- KFF Health News Original Stories 3
- The Last Decade’s Culture Wars Drove Some States To Fund Stem Cell Research
- Kentucky's Exchange Success Doesn't Translate To Small Business Participation
- Marketplace Plans Covering Out-Of-Network Care Harder To Find
- Political Cartoon: 'Best Shot'
- Health Law 2
- Consumers Urged To Shop Carefully For 2016 Marketplace Plan To Save Money, Get Best Care
- Failure Of Health Law Co-Ops Draws Congressional Scrutiny, Shakes Up Some State Insurance Markets
- Marketplace 2
- Administration Warns States Against Limiting Costly Hepatitis C Drugs In Medicaid Programs
- Blood-Testing Startup Theranos Looks For New Laboratory Director
- Capitol Watch 2
- Brady Takes Top Spot At Ways And Means While Some House Republicans Shift Focus From Planned Parenthood Funding Battles
- House Panel Advances Mental Health Bill, But Dems Complain Their Concerns Weren't Met
- State Watch 3
- Kansas Medicaid Costs Likely To Exceed 2016 Estimates
- Puerto Rico Financial Woes Trigger Rally To Urge Washington To Improve Health Care Funds For U.S. Territory
- State Highlights: Calif. Hospitals Could Cut Inpatient Costs 25%, Analysis Finds; CDC Investigating E. Coli Outbreak In Ore. And Wash.
From KFF Health News - Latest Stories:
KFF Health News Original Stories
The Last Decade’s Culture Wars Drove Some States To Fund Stem Cell Research
When the Bush administration choked federal funding for research involving cells taken from human embryos, some states opted to start their own programs. (Guy Gugliotta, 11/6)
Kentucky's Exchange Success Doesn't Translate To Small Business Participation
Despite strong enrollment in Kentucky's online health insurance marketplace, participation in its exchange for small employers also created by the Affordable Care Act has mostly been a dud. (Phil Galewitz, 11/5)
Marketplace Plans Covering Out-Of-Network Care Harder To Find
Two studies analyze the decline in PPO plans that provide some coverage when patients seek care from doctors, hospitals and other providers that are not on the plan’s network. (Michelle Andrews, 11/6)
Political Cartoon: 'Best Shot'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Best Shot'" by Jerry King.
Here's today's health policy haiku:
DEBATE OVER MEDICARE, OTHER BENEFITS DIVIDES GOP
Republican angst
Over entitlement growth
But how to fix it?
- Beau Carter
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
Summaries Of The News:
Consumers Urged To Shop Carefully For 2016 Marketplace Plan To Save Money, Get Best Care
The process of buying a health plan can be complicated and several outlets provide tips for shoppers and advice about what to consider. At the same time, federal officials are heating up their enrollment campaigns, including an appearance by the HHS secretary in New Jersey.
The Fiscal TImes:
Why You Might Be Choosing The Wrong Obamacare Plan
Shopping for health insurance can be a baffling maze of unfamiliar terms and puzzling acronyms — premiums, deductibles, PPOs, HMOs, POS. The Affordable Care Act, also known as Obamacare, added new elements that can heighten the confusion: Consumers have to navigate four different levels of plans, determine what subsidies they’re eligible for based on their income and calculate what plan would work best for them over the coming year. That’s why some Obamacare shoppers who signed up through healthcare.gov have chosen plans that cost too much. (Dent, 11/5)
The Oregonian:
5 Things You Need To Do When Buying Health Insurance
Steven Conner, a 56-year-old self-employed contractor in Gresham, learned recently his health plan premium will jump by $145 a month. Conner is not alone. In June the state approved significant hikes for the more than 240,000 Oregonians who buy their own policies and are not on Medicare. (Budnick, 11/5)
Marketplace:
Insurers Offer Narrower Networks On Health Exchanges
When open enrollment began on the nation's healthcare exchanges on November 1, many people who bought insurance for 2015 found that the 2016 plans they had to choose from have narrower networks of hospitals. In addition, premiums might be significantly higher. Insurers have asked the federal government for permission to increase premiums by as much as 40 percent or more. (Safo, 11/5)
The Wall Street Journal:
New Federal Initiative Aims To Enroll Northern New Jersey’s Uninsured
When Health and Human Services Secretary Sylvia Mathews Burwell hosts a round-table discussion Friday at a health clinic in Jersey City, N.J., she is expected to do the predictable: encourage people to enroll in health insurance offered through the Affordable Care Act. More surprising is a new federal enrollment effort targeted for northern New Jersey. The state typically fares better than many other states when percentages of the uninsured are compared. ... the northern part of the state has characteristics that make it ripe for an increase in health-insurance sign-ups, including a significant population of Hispanic residents, who are more likely to be uninsured than non-Hispanic whites. (Ramey, 11/5)
The Wall Street Journal:
Number Of Uninsured In U.S. Declines In First Half Of Year
An estimated 9% of Americans were uninsured in the first half of 2015, a significantly lower rate than in years before the health law was in effect, according to new federal government figures published Thursday. (Radnofsky, 11/5)
National Journal:
The Price Of Bucking Obamacare Is About To Increase—Will People Still Pay It?
The fee levied on those who go without insurance but who can afford it sharply increases in 2016, a result of a three-year phase-in of the penalty. The higher the fee, health experts say, the likelier it is that consumers will choose to get or stay covered. But there’s a big caveat: It all depends on whether or not uninsured Americans, or those thinking about leaving the exchanges, know about the individual mandate and its steep fee increase. ... The fee for not having health insurance next year won’t be felt until Americans file their federal taxes due April 2017. But it’s much more than in the past: $695 per adult and $347.50 per child, or 2.5 percent of a household’s income—whichever is higher. (Roubein, 11/5)
And in news about state health marketplaces -
Minnesota Public Radio:
Assessing The Usefulness Of MNsure's New Shopping Tool
Open enrollment for individual health insurance plans got underway over the weekend and so far MNsure reports that its computer systems and call center are operating that way they are supposed to. (Wurzer and Zdechlik, 11/5)
The Washington Post:
Maryland To Seek More Money From Health-Exchange Vendors
Maryland’s attorney general sent a letter to lawmakers last week complaining that an upcoming audit could undermine efforts to recover money spent on the state’s flawed health exchange by focusing on mistakes made by government officials rather than the vendors who built the portal. (Nirappil, 11/5)
Meanwhile, The Huffington Post examines what the Kentucky governor's election may mean for the health law -
The Huffington Post:
GOP Win In Kentucky 'Heartbreaking' For Obamacare Advocates
Kentucky attracted the national spotlight over the past two years as the state slashed its uninsured rate and implemented Obamacare more smoothly than President Barack Obama himself. Progressive activists and health care advocates fear that's all in jeopardy after Tuesday's victory by conservative Republican Matt Bevin in the race to be the next governor. (Young and Cohn, 11/5)
Failure Of Health Law Co-Ops Draws Congressional Scrutiny, Shakes Up Some State Insurance Markets
The collapse of 12 out of 23 nonprofit health insurance co-ops provides critics a new chance to take aim at the health law.
The Wall Street Journal:
Failure Of Half Of U.S. Health Insurance Co-Ops Sparks New GOP Criticism
Several Republicans Thursday heaped blame on the Obama administration for the failure of more than half of the cooperatives set up under the health law to infuse competition into the insurance market. The collapse of 12 out of 23 operating co-ops is providing a fresh opportunity for the GOP to criticize the Affordable Care Act and make the health law a talking point in the presidential election. The criticism was aired at a hearing by a House Energy and Commerce subcommittee to examine the failing startups, which received more than $1 billion in federal loans that may not be paid back. (Armour, 11/5)
McClatchy:
Congress Continues Probe Into Failing Obamacare Co-Ops
The nonprofit, member-run health insurance plans created by the Affordable Care Act are in a world of trouble. Twelve of the nation’s 23 Consumer Operated and Oriented Plans, known as co-ops, won’t provide coverage in 2016 after collapsing under the weight of low enrollment, financial problems and a host of technical and operational issues. (Pugh, 11/5)
The Arizona Republic:
Arizona's Health Insurance Co-Op Meritus Fights Closing
Executives with Arizona’s health insurance co-op are attempting to convince the Arizona Department of Insurance’s director to reverse an order that effectively put the non-profit out of business. (Alltucker, 11/5)
The Detroit Free Press:
Michigan Insurer Consumers Mutual Exits Marketplace
After days of speculation, a Michigan insurer — a one-of-a-kind entity in Michigan created under federal health reform — is pulling its business from the state's online marketplace. East Lansing-based Consumers Mutual will "enter into a run-off of its business," according to a statement from the Michigan Department of Insurance and Financial Services. The co-op established under the 2010 Affordable Care Act is far from alone in its decision. About a dozen altogether have closed recently, according to national news reports. (Erb, 11/5)
Meanwhile, KHN offers this report on the SHOP program -
Kaiser Health News:
Kentucky’s Exchange Success Doesn’t Translate To Small Business Participation
Kaiser Health News staff writer Phil Galewitz reports: "Kentucky has run one of the most successful Obamacare individual health insurance exchanges, attracting enough people into private health plans and Medicaid to cut the state’s uninsured rate by half in two years. But Kentucky’s online health insurance marketplace for small employers also created by the Affordable Care Act has mostly been a dud. Just 92 employers have signed up and a total of 901 people, both workers and their dependents, have received coverage through the specialized exchange." (Galewitz, 11/5)
Administration Warns States Against Limiting Costly Hepatitis C Drugs In Medicaid Programs
The federal officials also sent letters to drug makers asking what efforts they have pursued to make the drugs more affordable. In other news, a look at how the powerful drug makers' lobby is responding to recent reports of price hikes, and Pfizer announces it is increasing its drug assistance program for patients.
The Wall Street Journal:
Federal Officials Warn States On Hepatitis C Drug Restrictions
In a sign of growing government interest in rising prescription-drug costs, federal officials on Thursday said state Medicaid programs may be violating federal law by denying patients expensive hepatitis C medications. They also asked drug makers to provide information on their pricing arrangements with health insurers, which officials said could help ease the financial burden on state budgets. (Walker, 11/5)
The Associated Press:
Feds Worry That Low-Income People May Not Get Hepatitis Cure
Confronting the consequences of high-priced drugs, the Obama administration Thursday pointedly reminded states that they cannot legally restrict access by low-income people to revolutionary cures for liver-wasting hepatitis C infection. The federal Centers for Medicare and Medicaid Services also sent letters to several drug manufacturers, requesting details of what they are doing to make their medications more affordable. Among the companies getting federal letters was California based Gilead Sciences, maker of market-leading Harvoni. (Alonso-Zaldivar, 11/5)
Bloomberg:
Gilead, AbbVie Asked By U.S. For Hepatitis C Pricing Options
Drugmakers including Gilead Sciences Inc. and AbbVie Inc. were contacted by the U.S. government’s Medicaid agency to discuss options for how to pay for hepatitis C cures whose costs have eaten into state budgets. The companies, along with Johnson & Johnson and Merck & Co., were asked in letters from the Centers for Medicare and Medicaid Services to provide information on arrangements they make with health insurers to link payments to the outcomes of their treatments. Such arrangements may affect the prices that drugmakers are required to offer under the Medicaid program, the agency said Thursday. (Tracer, 11/5)
STAT:
Under Siege Over Price, Drug Makers Ready Their Counterpunch
Not long ago, it would have been almost unimaginable for PhRMA — short for the Pharmaceutical Research and Manufacturers of America — to criticize any company in its field. But faced with nationwide rebukes and attacks from presidential candidates over drug prices, the industry group is confronting a public storm unlike any in years. In response, according to lobbyists, congressional aides, and pharmaceutical executives, PhRMA is not only aggressively criticizing what it perceives as bad actors but also deliberating internally how to rehabilitate the industry’s image. (Scott, 11/6)
The Associated Press:
Pfizer Doubling Patient Income Limit For Drug Program
Pfizer, the biggest U.S.-based drugmaker, is increasing its financial assistance to patients, doubling the allowable income level for people to receive dozens of Pfizer medicines for free. The move comes amid fierce criticism by patients and politicians, as well as government investigations, of soaring prices for new medications and even old ones with little or no competition. (Johnson, 11/5)
Bloomberg:
Valeant's Drop Continues Unabated As Stock Falls Below $80
Valeant Pharmaceuticals International Inc. dropped below $80 a share for the first time in more than two years as investors grappled with the drugmaker’s mounting challenges and a top shareholder, Bill Ackman, discussed how his confidence in the company’s leadership had briefly wavered. Valeant has been under pressure over how it prices its drugs and its relationship with Philidor Rx Services, a mail-order pharmacy that it cut ties with on Oct. 30. Members of Congress said Wednesday that they want to investigate Valeant’s pricing practices. (Bloomfield, 11/5)
Blood-Testing Startup Theranos Looks For New Laboratory Director
The company launches the search amid questions about the qualifications of its current lab leader. The New York Times also reports on the need for investing expertise at health care tech firms like Theranos.
The Wall Street Journal:
Theranos Searches For Director To Oversee Laboratory
Diagnostics startup Theranos Inc. is seeking to hire a laboratory director to oversee one of its key facilities amid questions raised in laboratory circles about the qualifications of a physician who now runs the lab. The blood-testing company has been operating its Newark, Calif., lab for the past 10 months under the supervision of Sunil Dhawan, a dermatologist without a degree or board certification in pathology or laboratory science. (Carreyrou, 11/5)
The New York Times:
Why Health Care Start-Ups Like Theranos Need Investing Expertise
The Silicon Valley start-ups that often grab headlines are typically in the Internet and consumer technology world. But there’s another part of start-up land that is also highly active: health-related technology, which includes biotech, health care services and medical devices. (Benner, 11/5)
Meanwhile, on the Senate side, a bipartisan Medicare bill addressing chronic illness issues may soon emerge from the Finance Committee.
The Washington Post:
Brady To Be Next Ways And Means Chair
Rep. Kevin Brady will be the next chairman of the powerful Ways and Means Committee, where he will oversee tax laws and large entitlement programs, such as Social Security and Medicare. The Texas Republican was formally approved for this post by the full House Republican conference Thursday morning after being nominated for the job on Wednesday by a panel of House GOP leaders. (Snell, 11/5)
The Wall Street Journal:
House Republicans Eye Targets Beyond Planned Parenthood
A number of congressional Republicans are moving away from making Planned Parenthood funding their biggest goal in coming spending battles and instead are looking to pick more winnable policy battles such as curbing the Internal Revenue Service or environmental regulations. Not all Republicans are willing to abandon a campaign popular among GOP voters and activists to strip federal funding from the women’s health organization. (Peterson, 11/5)
Real Clear Politics:
Senate Panel May Have Draft Medicare Bill Soon
America’s rapidly aging population and the projected costs of millions of people struggling with multiple chronic illnesses may spawn bipartisan legislation “sooner rather than later,” staff experts who serve the top Republican and ranking Democrat on the powerful Senate Finance Committee said Thursday. In a national political environment in which health care and Medicare policies are assumed to divide the two parties, aides to Finance Committee Chairman Orrin Hatch and his Democratic colleague, Sen. Ron Wyden, struck a decidedly collaborative note during a discussion hosted by RealClearHealth. (Simendinger, 11/5)
House Panel Advances Mental Health Bill, But Dems Complain Their Concerns Weren't Met
In a fierce clash at the hearing, Democratic lawmakers say that they were not allowed to contribute to the bill, despite promises that their issues would be addressed.
The Hill:
Mental Health Reform Bill Advances After Clash
A House panel on Wednesday advanced a sweeping mental health reform bill after a fiery debate where Democrats objected that they had been cut out of the process. The bill, sponsored by Rep. Tim Murphy (R-Pa.), which overhauls the system for treating seriously mentally ill people, was billed as the Republican response to the 2012 Sandy Hook Elementary school shooting when the measure was first introduced in 2013. It has been controversial and delayed for years, but is now starting to move forward. The House Energy and Commerce health subcommittee advanced it on a mostly party line vote of 18-12 on Wednesday. (Sullivan, 11/4)
Morning Consult:
Sparks Fly in Usually Amicable Committee Over Mental Health Bill
Rep. Fred Upton (R-Mich.) has made bipartisanship a key tenet as chairman of the House Energy and Commerce Committee. On Wednesday, that comity fell apart. At an uncharacteristically chaotic and lengthy subcommittee meeting, Republicans and Democrats duked it out over a divisive and long-stalled mental health bill. Democrats’ attacks were mainly leveled at the bill’s sponsor, Rep. Tim Murphy (R-Pa.), who they said did not negotiate with them. (Reid, 11/4)
CQ Healthbeat:
House Subcommittee Advances Mental Health Bill
Legislation to overhaul the mental health system was advanced by a House subcommittee on Wednesday evening without resounding support from Democrats – a sign that efforts to address the complex issue of mental health could be an uphill battle in Congress. After a marathon markup that saw nearly 30 amendment votes, the Energy and Commerce Subcommittee on Health backed 18-12, mostly along party lines, an amended measure (HR 2646) that would redirect federal funds from the Substance Abuse and Mental Health Services Administration to programs that focus on serious mental illness. (Zanona, 11/5)
Sanders Seeks To Regain Campain-Trail Momentum By Pushing Policy Initiatives
The Democratic candidate is looking at speeches that will likely include policy proposals on family and medical leave, a Medicare-for-all health care system and an expansion of Social Security benefits. The speeches are under consideration as Sen. Bernie Sanders is losing the battle for support among unions. Meanwhile, rival Hillary Clinton will meet with insurers. News outlets also report campaign trail news from Ben Carson and Jeb Bush, both candidates for the Republican presidential nomination.
Los Angeles Times:
Bernie Sanders' Momentum Stalls In An Unlikely Place: Union Halls
Despite Sanders’ deep support for labor, the national nurses’ organization that Almada sought to join is the only major union to endorse Sanders in the race for the Democratic nomination for president. It is dwarfed by much larger labor groups that are lining up with his arguably less committed, less reliable rival, Hillary Rodham Clinton. National unions representing more than half of America’s 14.6 million unionized workers are already in Clinton’s corner, and many of the rest are heading in that direction. It is creating significant tension in some of the organizations and raising the question of whether the Sanders campaign is faltering or if union leadership has lost touch with its rank and file, large numbers of whom are turning out to support Sanders with unrivaled enthusiasm. (Halper, 11/6)
The Associated Press:
Seeking To Regain Traction, Sanders Plans New Policy Push
Sanders’ campaign is considering a speech, possibly in New York, to provide more details on his economic policies, including how he would seek to structure tax rates to pay for his domestic policy agenda and seek to regulate Wall Street. Other topics he plans to address are how he would serve as commander-in-chief and a domestic policy agenda that will include proposals on family and medical leave, a Medicare-for-all health care system and an expansion of Social Security benefits. (Lerer and Thomas, 11/6)
Politico Pro:
Clinton Campaign Meets With Insurers
Hillary Clinton is keeping her enemies close. Top campaign staffers are hosting insurance executives at Brooklyn headquarters this week, coming face-to-face with an industry that Clinton ranked among her top enemies during the first Democratic debate — alongside drug companies, the NRA, Iran and Republicans. (Norman and Pradhan, 11/5)
The Washington Post:
Ben Carson’s First Foray Into Politics, On Both Sides Of A 1992 Abortion Debate
The doctor wore hospital scrubs and spoke directly to the camera. “Let us not be duped,” Ben Carson said. It was 1992. Maryland voters were about to decide on a ballot measure proposing to loosen state restrictions on abortion. Abortion opponents had a powerful new ally: the daring neurosurgeon whose up-from-poverty story had made him a Baltimore hero. ... “A humdinger,” thought Frederica Mathewes-Green, an antiabortion activist. But then, after the ad had run for 10 days, a colleague called her to the office TV. “There he was, standing behind the podium with their logo on it and saying that he didn’t know this would be a political ad,” Mathewes-Green recalled. Carson was at a news conference, organized by abortion rights activists. He was denouncing his own ad. That episode was one of Carson’s first forays into politics, and it left both sides of the fight thoroughly bewildered. (Fahrenthold and Weigel, 11/5)
Politico:
Bush Shares More About Daughter's Addiction Struggles
Jeb Bush is opening up about his daughter’s struggle with drug addiction. The former Florida governor has addressed the issue before, and he has discussed his own use of marijuana when he was young, but he spoke more emotionally about his daughter Noelle's addiction in an interview with The Huffington Post posted on Thursday. (Collins, 11/5)
Kansas Medicaid Costs Likely To Exceed 2016 Estimates
In other state-level Medicaid news, AstraZeneca and Teva reached a multistate agreement in a Medicaid drug pricing case.
Wichita (Kan.) Eagle:
Medicaid Costs For Kansas Will Be Higher Than Expected In 2016
Medicaid will cost the state more than the Legislature expected when it passed a budget in June. Budget officials met last week to review caseloads for the state’s Medicaid, foster care, and welfare systems, determining that the overall cost of the state’s human services would be $48.9 million more than the amounts approved by the Legislature. ... Most of the funding difference can be attributed to KanCare, the state’s privatized Medicaid system, which provides health coverage to poor and disabled Kansans. KanCare will cost $40.1 million more from all funding sources for the 2016 fiscal year, which began in July, with $19.4 million of that coming out of the state general fund. The memo says this extra cost can be attributed to a slight growth in population, rising pharmaceutical costs and increases in costs associated with the Affordable Care Act insurers fee. (Lowry, 11/5)
Reuters:
AstraZeneca, Teva Reach Deal With States In Medicaid Pricing Case
Drugmakers AstraZeneca Plc and Cephalon, a unit of Teva Pharmaceutical Industries Ltd , reached a multistate accord on Wednesday over civil charges they overbilled state Medicaid programs, the New York Attorney General announced. The settlement with the states comes after the U.S. Justice Department settled parallel civil charges with both companies in July. The $54 million to be collectively paid was previously announced by the Justice Department. Of that amount, AstraZeneca is responsible for $46.5 million and Cephalon for $7.5 million. (Lynch, 11/5)
The rally included thousands of island residents -- some of whom were hospital workers wearing scrubs -- and a U.S. delegation featuring legislators, officials and labor and civil rights advocates. The demonstrators hope to focus attention on the U.S. territory's Medicaid reimbursement rates, which are reportedly 70 percent lower than rates on the mainland.
The Associated Press:
NY Governor, NYC Mayor Join Puerto Rico Health Care Rally
New York Gov. Andrew Cuomo and New York City Mayor Bill de Blasio joined thousands of demonstrators Thursday demanding equal treatment for Puerto Rico on federal health care. The demonstrators were protesting Medicaid reimbursements in the U.S. territory that officials say are 70 percent lower than on the U.S. mainland and Medicare reimbursements that are 40 percent lower. (11/5)
NBC News:
Thousands Rally In Puerto Rico For U.S. Action On Healthcare Crisis
While U.S. residents may have seen recent headlines about Puerto Rico's financial situation, many may not be aware of the island's deteriorating and frail healthcare system. On Wednesday, thousands of island residents were joined by a U.S. delegation of legislators, healthcare advocates, labor leaders and civil rights activists at a rally to call attention to the worsening situation. (Guzman, 11/5)
Reuters:
Thousands Rally In Puerto Rico For Better Healthcare
Tens of thousands of Puerto Ricans, including hospital workers wearing scrubs, rallied in San Juan on Thursday to press Washington to improve healthcare benefits for the indebted U.S. territory which is in the middle of a fiscal crisis. Puerto Rico, saddled with $72 billion in debt and a 45 percent poverty rate, defaulted on part of its debt in August. It receives less federal healthcare support than U.S. states and faces the impending dissipation in 2017 of a federal block grant, which could further squeeze Medicaid services. (Brown, 11/5)
News outlets report on health issues in California, Oregon, Washington, Florida, New Hampshire, New York, Pennsylvania and Massachusetts,
Los Angeles Times:
California Hospitals Could Cut Inpatient Costs 25% And Save $10 Billion, Study Says
California hospitals may be wasting $10 billion a year on excessive patient stays despite the state's reputation for tightly managed care, according to a new analysis of state data. The report finds that inpatient costs at 275 hospitals statewide could be reduced by 25%, yielding the $10 billion in savings among patients covered by Medicare, Medicaid and private health insurance. (Terhune, 11/5)
NPR:
CDC Investigating As E. Coli Outbreak Linked To Chipotle Sickens 39
The Centers for Disease Control and Prevention is assisting the Washington State Department of Health and the Oregon Health Authority in investigating an outbreak of E.coli infections linked to Chipotle Mexican Grill. Thirty-nine people have been sickened with a strain of E. coli known as Shiga toxin-producing Escherichia coli O26 (STEC O26) in Washington and Oregon. Fourteen people have been hospitalized in those two states. (Aubrey, 11/5)
WJCT:
Hospital Officials Push Back On 'Gouging' Claims
Gov. Rick Scott talked Tuesday with Jacksonville residents who said they’ve been the victims of hospital price gouging, while Florida hospital officials are calling Scott’s framing of the issue irresponsible and inaccurate. Florida Hospital Association President Bruce Rueben said Scott’s proposal amounts to price-capping -- something he said won’t work in an ever-evolving health care landscape. (Benk, 11/4)
The Associated Press:
Lung Cancer Patient Sues To Get Medical Marijuana ID Card
A New Hampshire woman with late-stage lung cancer filed a lawsuit against the state health commissioner Thursday in hopes of getting a medical marijuana identification card before dispensaries open. Under a state law passed more than two years ago, people suffering from a limited number of diseases and medical conditions can purchase marijuana with approval from their doctors. The Department of Health and Human Services started accepting applications this week from patients and their caregivers, but identification cards won't be issued until the Alternative Treatment Centers get authorization to start dispensing marijuana. (11/5)
The New York Times:
Doctor In Sheldon Silver’s Corruption Trial Denies Improper Relationship
Prosecutors alleged that the legislator had “funneled half a million dollars of taxpayer money and other official benefits” to the doctor for his cancer research, and that Dr. Taub in turn steered patients with asbestos-related legal claims to the law firm, which shared its fees with Mr. Silver. Mr. Silver has pleaded not guilty to fraud, extortion and money laundering charges. (Craig and Weiser, 11/5)
The Wall Street Journal:
In Sheldon Silver Trial, Testimony Turns To State Grants
Assemblyman Sheldon Silver and Robert Taub, the Columbia University oncologist at the center of one of the politician’s alleged schemes, were close enough that Mr. Silver would occasionally give Dr. Taub gifts such as handmade matzo, the physician testified on Thursday. But though the two “had a friendship,” Dr. Taub said he would keep referring his patients to the former Assembly speaker “because I may need him in the future—he is the most powerful man in New York State,” according to an email the physician sent his nurse in 2010. (Orden, 11/5)
News Service Of Florida:
Workers Comp Rates To Drop 5.1 Percent
State regulators issued an order Tuesday that calls for overall workers-compensation insurance rates to drop by 5.1 percent next year. The Office of Insurance Regulation rejected a smaller 1.9 percent decrease proposed by the National Council on Compensation Insurance, which annually proposes rates for workers-compensation insurers. Regulators gave the council, known as NCCI, until Monday to make a new filing with the required changes. The lower rates are expected to take effect Jan. 1. (11/5)
The Pittsburgh Tribune-Review:
Painkiller Mix-Up At Butler Memorial Hospital Puts Patients In 'Immediate Jeopardy'
Staff at Butler Memorial Hospital placed patients in immediate jeopardy when they injected them with a narcotic seven times more powerful than the one prescribed by their doctors, according to a state Health Department report. Hospital officials said no patients were harmed as a result of the errors, which occurred between Aug. 24 and 31. (Roche, 11/4)
The Associated Press:
Pennsylvania To Seek Stronger Child Immunization Regulations
The Pennsylvania departments of Health and Education say they'll seek changes to immunization regulations for school children that they say will better protect students from illness. The departments said Thursday that they would begin seeking regulatory approval to strengthen the current requirements. Those changes would include requiring students to receive their final dose within the first five school days, or at least show a health care provider's plan to complete a multi-dose immunization. (11/5)
The Philadelphia Inquirer:
Medical Device Critics Prevail In Clash With Renowned Hospital
A renowned Boston medical center was ordered by a judge Tuesday to stop imposing extraordinary security measures on a Bucks County cancer patient and her husband, who have been sharply critical of Brigham and Women's Hospital. The Massachusetts judge agreed with the couple, Amy Reed and Hooman Noorchashm, that the security was intended to intimidate them, and violated their right to free speech as well as the hospital's own policies. Reed, 42, an anesthesiologist at the University of Pennsylvania, and Noorchashm, 43, a cardiac surgeon at Thomas Jefferson University Hospital, have led a highly effective national campaign to ban a gynecological surgical device that Brigham doctors used to perform her hysterectomy two years ago. The tissue-slicing device, an electric morcellator, spread her hidden uterine cancer - a danger that they have since publicized. (McCullough, 11/5)
Stateline:
Some States Create Welcoming Environment For Surrogacy
Matt cried at the birth of his son a couple of weeks ago. His husband, Sylvain, was outwardly more composed, but no less transfixed as his newborn blinked his eyes at a bright, unfamiliar world. The woman who gave birth to the child was the calmest of the lot. A paid surrogate, she had had two fertilized eggs (from an egg donor) implanted in her uterus. All her responsibilities toward him ended at birth, while Matt and Sylvain, French nationals recently transplanted to New York City, dove into the deep end of parenting. That all this occurred in Oregon was not an accident. Although the state is home to far fewer surrogacy births than the much more populous California, it nonetheless has earned an outsized reputation as a place that welcomes surrogacy. (Ollove, 11/6)
Health News Florida:
Emergency Situation Declared At Florida Women's Reception Center
An oversight board has declared a health care emergency at a Florida women’s prison, according to records obtained by WMFE. The Correctional Medical Authority’s did an audit of the Florida Women’s Reception Center in Ocala. Inspectors found cases including a diabetic prisoner didn’t get insulin for two to three months and an inmate with a golf ball sized lump was denied an MRI in July, and still hasn’t seen a surgeon. (Aboraya, 11/5)
Research Roundup: Medicaid's Obesity Costs; Where Kids Get Mental Health Care
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Health Affairs:
Severe Obesity In Adults Cost State Medicaid Programs Nearly $8 Billion In 2013
Our analysis of population-representative data indicates that in 2013, severe obesity cost the nation approximately $69 billion, which accounted for 60 percent of total obesity-related costs. Approximately 11 percent of the cost of severe obesity was paid for by Medicaid, 30 percent by Medicare and other federal health programs, 27 percent by private health plans, and 30 percent out of pocket. Overall, severe obesity cost state Medicaid programs almost $8 billion a year, ranging from $5 million in Wyoming to $1.3 billion in California. These costs are likely to increase following Medicaid expansion and enhanced coverage of weight loss therapies in the form of nutrition consultation, drug therapy, and bariatric surgery. (Wang et al., 11/2)
Health Affairs:
Baltimore City Stores Increased The Availability Of Healthy Food After WIC Policy Change
As part of a 2009 revision to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, the Department of Agriculture required WIC-authorized stores to stock additional varieties of healthy food. ... Using surveys conducted in 118 Baltimore City, Maryland, food stores in 2006 and 2012, we examined associations of the change in healthy food availability with store type, neighborhood demographics, and the 2009 WIC policy change. Overall, healthy food availability improved significantly between 2006 and 2012 .... On an 11-point scale measuring availability of fruit (3 points), vegetables (4 points), bread (2 points), and milk (2 points), the WIC policy change was associated with a 0.72-point increase in WIC-relevant healthy food availability, while joining WIC was associated with a 0.99-point increase. (Cobb et al., 11/2)
Pediatrics:
Outpatient Visits And Medication Prescribing For U.S. Children With Mental Health Conditions
Using nationally representative data from the Medical Expenditure Panel Survey (MEPS) from 2008 to 2011, we determined whether children and youth aged 2 to 21 years with outpatient visits for mental health problems in the past year saw [primary care providers] PCPs, psychiatrists, and/or psychologists/social workers for these conditions. ... One-third (34.8%) of children receiving outpatient care for mental health conditions saw PCPs only, 26.2% saw psychiatrists only, and 15.2% saw psychologists/social workers only. Nearly a quarter (23.8%) of children saw multiple providers. ... PCPs prescribed medications to a higher percentage of children than did psychiatrists. Children seeing a PCP for ADHD were more likely to receive stimulants or α-agonists than children with ADHD seeing psychiatrists (73.7% vs 61.4%). (Anderson et al., November 2015)
The Kaiser Family Foundation:
Primary Care Physicians Accepting Medicare: A Snapshot
Previous studies show that the vast majority of physicians accept Medicare, but the proportion taking new Medicare patients is smaller, particularly among primary care physicians compared with specialists. ... This Data Note presents findings on reported acceptance of Medicare patients among non-pediatric primary care physicians, based on data from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers. ... The vast majority of non-pediatric primary care physicians (93 percent) say they accept Medicare—comparable to the share accepting private insurance (94 percent). A majority of primary care physicians also say they are also taking new Medicare patients (72 percent), but this share is somewhat lower than the share of primary care physicians accepting new privately insured patients (80 percent). (Boccuti et al., 10/30)
Here is a selection of news coverage of other recent research:
The Associated Press:
Studies Raise Questions About Impact Of Menu Calorie Counts
Tracking calories at chain restaurants is supposed to become easier next year, but new studies raise questions about whether the counts actually make a difference for diners and eateries. ... New York University researchers used receipts and surveys at McDonald's, Burger King, KFC and Wendy's to track customer purchases. In New York City where menus were labeled, calories averaged between 804 and 839 per meal, essentially the same as the 802 to 857 calories at fast-food locations in New Jersey that didn't post calorie content. (Neergaard, 11/2)
Stat/The Boston Globe:
Unvaccinated Babies Refused By Some Doctors
More than 20 percent of pediatricians “always” or “often” turn away families who decline to get their babies vaccinated, according to a survey released Monday by the American Academy of Pediatrics. Even so, dismissing families from a practice doesn’t happen all that frequently. Most pediatricians said just a small sliver of their patients refused to vaccinate babies. (Samuel, 11/2)
Reuters:
Stereotyping Makes Life Harder For Young Female Surgeons
Women in surgical training programs who feel that those around them endorse negative stereotypes about female doctors have poorer psychological health than others who do not feel a “stereotype threat,” a new study found. Not all women perceived a stereotype threat. And such perceptions did not affect the mental health of young women in non-surgical specialties, the researchers found. (Doyle, 10/30)
The New York Times:
Marriage May Bolster Recovery From Surgery
Being married may improve the odds of a good recovery after surgery, according to a new report. The study, in JAMA Surgery, included 1,567 people 50 and older who underwent cardiac operations — 1,026 married, 184 divorced or separated, 331 widowed and 35 never married. ... About 20 percent of married patients had either died or developed a new dependency within two years of their operations. But 28.8 percent of divorced or separated people and 33.8 percent of the widowed had these negative outcomes. Even after controlling for age, sex, smoking and other factors, compared with people who were married, the divorced, separated or widowed were at least 40 percent more likely to have died or acquired a new disability. (Bakalar, 11/2)
STAT:
Video Game Developers Covet A New Market: Patients
Hundreds of patients with mental illness are signing up to test an unusual experimental treatment: video games.It’s part of a bold push by several companies, led by two Boston startups, to secure permission from federal regulators to market their video games as medical therapies, to be prescribed by physicians for conditions ranging from depression to autism to even, perhaps, Alzheimer’s disease. (Robbins, 11/5)
The Associated Press:
J&J, ViiV: 2 Injections Every Month Or 2 Could Control HIV
Preliminary testing of two long-acting injectable drugs indicates it might be possible to keep HIV at bay indefinitely with injections every month or two. Johnson & Johnson and partner ViiV Healthcare, which specializes in HIV drugs, on Tuesday announced results from the first 32 weeks of the planned 96-week study, which combines one drug from each company. Significant additional testing is needed, but the combination treatment would be a first if approved and could eventually be a huge advance over a disease once almost universally fatal. (Johnson, 11/3)
The Philadelphia Inquirer:
Uncontrolled Diabetes Can Lead To Serious Eye Problems
Three years ago, Allison Turner noticed her vision was getting a little blurry. "I knew I had to see a doctor," she said. "But I was scared and didn't deal with it." The result was that when Turner, a professor of public policy and administration at West Chester University, awoke one morning, she couldn't see out of her left eye. A trip to a retina specialist confirmed she had suffered a detached retina caused by diabetic retinopathy. (Rush, 11/2)
The Philadelphia Inquirer:
What's The Best Treatment For People Who Are Having Strokes?
A new study adds to the evidence that a technique that uses a catheter to physically grab a blood clot leads to better results than drugs that break clots up. ... researchers at McMaster University used data from eight randomized clinical trials that involved 2,423 stroke patients. Of those, 1,313 received what’s called endovascular thrombectomy, or physical removal of the clots. That is often done with a device known as a stent retriever. The remaining patients received the current standard of care, which is treatment with the drug tissue plasminogen activator or tPA. (Burling, 11/3)
Viewpoints: Keep Health Costs Down; Political Riders May Heat Up Budget Battle
A selection of opinions on health care from around the country.
The New York Times:
Great News! We’re Not Doomed To Soaring Health Care Costs
It really matters who the next president is. But there are other things that matter just as much to the nation’s future prosperity. One of them is: What is happening to health care costs? If health care costs start to rise again the way they did before, then health care spending will swallow the economy and bankrupt the federal government. If they are contained, then suddenly there’s a lot more money for everything else, like schools, antipoverty efforts and wages. The good news is that recently health care inflation has been at historic lows. (David Brooks, 11/6)
The Washington Post:
The Budget Battle Isn’t Over. It’s Just Beginning.
If you think the budget fight is over, you’re sorely mistaken. It’s just heating up. See, for the most part, appropriations bills have language that looks like this: “For carrying out titles I and II of the Imaginary Piece of Legislation Act, $10,000,000 shall be available.” But lately legislators have been littering appropriations bills with language that looks more like this: “None of the funds made available by this Act may be used to implement [law/rule/regulation we hate].” In other words, a backdoor repeal. If you can’t beat ’em, defund ’em. Can’t successfully repeal Obamacare, despite more than 50 votes to do so? No worries. Just craft a health-care appropriations bill that explicitly prevents any funds from being “used to implement, administer, enforce, or further any provision” of the Affordable Care Act. (Catherine Rampell, 11/5)
Bloomberg:
A Republican Can Kill Obamacare. Will He?
Kentucky just volunteered to be a national political experiment, and it can't help but be an edifying one for the whole country. Ever since the 2010 passage of the Affordable Care Act, Republicans have worked to sabotage the law and have done their best Yosemite Sam imitations to show the folks back home how furious they are at that varmint Barack Obama who signed it. Democrats have operated on the theory that Sam's six-shooter fires only blanks. If offered a genuine opportunity to repeal health insurance coverage for millions of Americans, would Republicans go through with it? The election of Matt Bevin as governor of Kentucky ought to settle the question. (Francis Wilkinson, 11/5)
Five Thirty Eight Politics:
Thousands Could Become Uninsured If Kentucky Freezes Medicaid
Throughout his campaign for Kentucky governor, Matt Bevin, a Republican who won the election Tuesday, railed hard against the Affordable Care Act, promising to repeal the state’s expansion of Medicaid under the law. He has recently pulled back on that vow, saying he will instead freeze the program and prevent new enrollment. He may not be able to implement such a freeze — it would require a waiver from federal authorities, who will probably block it — but if he does get his way, a freeze is likely to eliminate health coverage for thousands of low-income people. (Anna Maria Barry-Jester, 11/5)
The Fiscal Times:
Collapsing Obamacare Co-Ops Signal Big Trouble To Come
A key piece of the Obama administration’s plan to control the health insurance market is in a state of collapse. With it will go the philosophical underpinning of big government solutions to private-sector problems--and that will pose a core question for voters in the upcoming national elections. (Edward Morrissey, 11/5)
The San Antonio Express-News:
Preordained Judgment On Medicaid Defunding?
The federal government has warned Texas that it cannot block Medicaid participants from “qualified providers of their choice” or because of the provider’s “scope of practice.” In doing so, the U.S. Department of Health and Human Services has essentially put the state on notice that it is fooling no one on the reasons it is trying to oust Planned Parenthood from the program. (11/5)
Minneapolis Star Tribune:
Palin's In The Past As Medicare Moves Beyond 'Death Panels'
Thankfully, the nation has moved on from the reckless “death panel” rhetoric that could have derailed a compassionate new policy that would help millions of patients do end-of-life planning before a medical crisis strikes. On Oct. 30, the federal agency overseeing Medicare finalized a policy that will pay medical providers to advise patients on advance-care planning. ... Regrettably, this sensible initiative is years in the making. In 2009, former Republican vice presidential candidate Sarah Palin made death panels a national buzzword, wielding it so effectively that officials eventually backed off including payments in the 2010 Affordable Care Act. (11/5)
The Wall Street Journal:
How About Fraud Alerts For Health-Care Charges?
Each year the Centers for Medicare and Medicaid Services pays more than $853 billion in health-care claims, amounting to almost 25% of the federal budget. But an estimated 10% of the claims paid are fraudulent. This year alone, the federal government will pay about $85 billion in fraudulent claims. That is more than the combined earnings of Exxon, Wells Fargo and Microsoft. Most people would be surprised to hear that government health-care programs are “trust-based” systems that rely on the good faith of medical providers to bill only for legitimate services. The government does little to assess the legitimacy of a claim before paying it.(Hank B. Walther, 11/5)
Stateline:
Rethinking Methadone As A Preferred Treatment For Pain
More than 16,000 Americans die each year from prescription opioid overdoses, with a disproportionate number of these deaths attributed to methadone. Now, the federal government is calling on states to consider removing methadone from the list of preferred drugs used as pain relievers for Medicaid patients. This proposal is part of a larger White House initiative to stop the nation’s prescription drug abuse epidemic. (Cynthia Reilly, 11/5)
The Washington Post:
How Asian American Women Became The Target Of Anti-Abortion Activism
Purvi Patel, a 33-year-old Indian-American woman, is sitting in an Indiana prison serving a 20-year sentence for fetal homicide. Last spring, she became the first woman in the country to be imprisoned on that charge for allegedly ending her own pregnancy .... In 2011, Bei Bei Shuai, a Chinese immigrant, attempted suicide and lost her pregnancy in the process. She also was charged under Indiana’s feticide law, but pled guilty to a lesser charge. ... Across the country, Asian American women’s reproductive rights are being challenged and their family-planning decisions are being policed based on racial stereotypes held by anti-choice activists and officials. (Miriam Yeung, 11/4)
The New York Times:
The Push For Legal Marijuana Spreads
Support for making marijuana legal is increasing around the world, and that is a good thing. Earlier this week, the Mexican Supreme Court opened the door to legalizing the drug by giving four plaintiffs the right to grow cannabis for personal use. (11/5)