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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Feb 2 2015

KFF Health News Original Stories 2

  • Why Florida Is No. 1 In Obamacare Enrollment Despite GOP Opposition
  • California Ranks Last In Spending On Diabetes Prevention, Audit Finds

Capitol Watch 1

  • For GOP, Dismantling The Health Law Remains Top Priority

Administration News 2

  • As Obama Unveils His Budget, Rift With GOP On Entitlement Spending Remains
  • Obama Outlines Ambitious 'Precision Medicine' Initiative

Health Law 3

  • States Continue -- In Fits And Starts -- To Contemplate Medicaid Expansion
  • Minn. Lawmakers Want A More Accountable Health Exchange
  • Making Too Much For Medicaid, Some Choose More Work To Get Subsidies

Health IT 1

  • HHS Pushes Information Sharing For Electronic Health Record Systems

Public Health 1

  • Efforts To Contain Measles Outbreak Involve Infection Control Expertise And Detective Work

State Watch 1

  • State Highlights: Sutter, Blue Shield Resolve Calif. Health Care Contract Dispute; Hawaiian Health Workers Start 6-Day Strike

Editorials And Opinions 1

  • Viewpoints: 'Lunacy' In Vaccine Views; Jindal Blasts Some Health Law Replacement Efforts

From KFF Health News - Latest Stories:

KFF Health News Original Stories

Why Florida Is No. 1 In Obamacare Enrollment Despite GOP Opposition

More Floridians have signed up for private health exchange plans than in any other state thanks to online mapping tools, coordinated outreach efforts and insurers’ involvement -- and in spite of Republican opposition. ( Phil Galewitz , 2/2 )

California Ranks Last In Spending On Diabetes Prevention, Audit Finds

With one in 12 residents estimated to suffer from diabetes, California spends less on prevention per person than any other state, according to a state audit. ( Barbara Feder Ostrov , 2/2 )

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Summaries Of The News:

Capitol Watch

For GOP, Dismantling The Health Law Remains Top Priority

The House will vote this week on a measure to repeal the overhaul, while Republican lawmakers continue debating whether they should use the controversial process known as reconciliation and then replace the law with their own alternative.
The Wall Street Journal: GOP Lawmakers Weigh Contentious Tactic To Dismantle Health Law

Republican lawmakers and aides say there is broad enthusiasm for using the process known as reconciliation to try to repeal the 2010 health care law and potentially replace it with a GOP alternative. Another contender, looking less likely now, is using the process for a tax overhaul. (Peterson and Crittenden, 1/30)

Fox News: GOP House To Vote Next Week To Repeal Obamacare, After Attacking Law Piece By Piece

The Republican-led House is set to begin February with a vote to repeal Obamacare, making clear that trying to dismantle the health care law remains a top priority. (2/1)

Politico: GOP Chairmen To Lead Task Force To Develop Obamacare Alternative

Three powerful committee chairmen — including Rep. Paul Ryan — will lead a working group to develop an alternative to Obamacare, the House Republicans’ most serious attempt thus far to develop their health care reform package, according to GOP sources. (Sherman and Bresnahan, 1/30)

Meanwhile, news outlets offer status checks on the Supreme Court and how its review of King v. Burwell could give the GOP an important assist in these efforts -

The Fiscal Times: Will The Supreme Court Help The GOP Repeal Obamacare?

Republican lawmakers are still vowing to repeal Obamacare — but this time they’re banking on the Supreme Court to help them. If the Court rules against the administration in the much-anticipated case of King v. Burwell, some 6 million people would lose their subsidies and far fewer people would be able to buy coverage on the insurance exchanges. This could have enormous implications that could upend the entire law. (Ehley, 2/1)

CNN: Where We Are In The Supreme Court Term

On March 4, the Court will hear a challenge to a section of the Affordable Care Act concerning the subsidies available to individuals who purchase competitively priced insurance from the American Health Benefit Exchanges. As things stand now, 16 states and the District of Columbia have established their own exchanges, while 34 states have opted to have federally-facilitated Exchanges. At issue: who qualifies for the subsidies? (De Vogue, 2/2)

In addition, the health law's medical device tax is a prime target -

Politico: Lobbying Push Puts Obscure Tax At Top Of Obamacare Repeal Agenda

An obscure Obamacare tax on medical devices has emerged as the Republicans’ best chance of repealing part of the health care law this year. The tax may not be what ordinary Americans who oppose Obamacare focus on — or even know about. (Norman, 2/2)

The Associated Press: Drive To Repeal Medical Tax No Slam Dunk In Congress

It flew through the Republican-run House in 2012, and a year later 79 of the Democratic-led Senate's 100 members embraced it. With Republicans now controlling both chambers of Congress, the chances for repealing the 2.3 percent tax on medical devices are better than ever. Yet abolishing the tax won't be easy, even though Republicans rank it a top priority and are backed by Democrats from states that rely on the industry for jobs. (Fram, 1/31)

In other Capitol Hill news -

The Washington Post: How Rand Paul Tried To Lead An Eye Doctors’ Rebellion

The saga began in the 1990s, when Paul — now a senator representing Kentucky and a GOP presidential contender — hatched a plan to put his family’s free-market ideals into practice. He wouldn’t submit to the establishment. He would out-compete it by offering doctors an alternative with lower fees and fairer rules. His do-it-yourself medical board lasted more than a decade, becoming one of the most complex organizations Paul ever led on his own. But it didn’t work. Indeed, in a life of successes, it became one of Paul’s biggest flops. (Fahrenthold, 2/1)

Administration News

As Obama Unveils His Budget, Rift With GOP On Entitlement Spending Remains

Republicans want a program that drives down federal spending on food stamps, health programs and other safety-net costs, but Democrats argue that the health law is pushing health costs down.
The Associated Press: Obama Sending $4 Trillion Spending Plan To Congress

Even before the massive budget books landed on lawmakers’ desks, Republicans were on the attack, accusing the president of seeking to revert to tax-and-spend policies that will harm the economy while failing to do anything about the budget’s biggest problem — soaring spending on government benefit programs. Obama’s fiscal blueprint, for the budget year that begins Oct. 1, proposes spending $4 trillion — $3.99 trillion before rounding — and projects revenues of $3.53 trillion. (Crutsinger, 2/2)

The New York Times: Obama’s Plans For Deficit And Taxes Are Detailed On Eve Of Budget Proposal

President Obama will propose a 10-year budget on Monday that stabilizes the federal deficit but does not seek balance, instead focusing on policies to address income inequality as he adds nearly $6 trillion to the debt. ... Republicans will put forward ideas for controlling the main drivers of the deficit — Social Security and health care programs that are expanding with an aging population — and will propose a budget that does balance. But, [Rep. Paul] Ryan indicated, they are not likely to force a showdown on entitlements. (Weisman, 2/1)

The Washington Post: Obama Budget Would Fund Public Works Program With Tax On Overseas Profits

The administration said it “achieves these goals by replacing mindless austerity with smart reforms, paying for all new investments” and seeking new savings. That isn’t likely to appease Republicans, however, who are expected to quickly dismiss Obama’s budget request and start drafting their own blueprint that would seek to eliminate deficits entirely over the next 10 years and tackle the biggest drivers of government spending: Social Security and federal health programs. (Mufson and O'Keefe, 2/2)

Los Angeles Times: Obama Budget Seeks To Boost Middle Class, Close Gap On Income Inequality

The Republican preference is for continued austerity and lower taxes, which will probably be reflected in their own budget plans expected next month. To boost Pentagon spending as defense hawks want, their budgets are expected to slash more deeply into food stamps, healthcare and other safety-net programs. Rep. Tom Price (R-Ga.), the House Budget Committee chairman, promised Sunday on Fox News that a Republican budget would re-imagine Medicare, Medicaid and Social Security, and “will do what the American people have to do with their homes and in their businesses every single day — and that’s not spend more money than what comes in.” (Mascaro and Hennessey, 2/2)

Politico Pro: White House Sees Savings From Health Care Entitlements

The White House promised to reap savings from health care entitlements and to “support” the Affordable Care Act in a summary of the president’s budget put out before the release of the full document Monday morning. (Kenen, 2/2)

Modern Healthcare: Obama's Budget Seeks New Spending To Combat Diseases, Antibiotic Resistant Bacteria

The proposal will include new healthcare initiatives aimed at combating diseases, fighting antibiotic-resistant bacteria and overhauling the payment system for Medicare. The president wants to reverse cuts that were part of the sequestration deal hatched with Republicans and that have defined an era of fiscal austerity in Washington. Obama is expected to propose increasing annual spending by roughly $70 billion, or 7 percent, over the current fiscal year. (Demko, 1/30)

Obama Outlines Ambitious 'Precision Medicine' Initiative

This $215 million biomedical research effort announced Friday by President Barack Obama includes plans to collect genetic data on a million Americans with the hope of gaining insights into the causes of diseases and how to treat them.
The New York Times: U.S. To Collect Genetic Data To Hone Care

Saying that “the possibilities are boundless,” President Obama on Friday announced a major biomedical research initiative, including plans to collect genetic data on one million Americans so scientists could develop drugs and treatments tailored to the characteristics of individual patients. (Pear, 1/30)

The Wall Street Journal: Obama Announces $215 Million Precision-Medicine Genetic Plan

President Barack Obama on Friday laid out an ambitious effort to amass genetic data on one million or more Americans, a plan aimed at discovering genetic causes of disease and finding new drugs that will target dangerous mutations. Speaking at the White House, Mr. Obama called the $215 million Precision Medicine Initiative “one of the biggest opportunities for breakthroughs in medicine that we have ever seen.” (Burton, Rockoff and Winslow, 1/30)

The Washington Post: Obama Touts ‘Lifesaving’ Potential Of Personalized Medicine

In recent years, targeted therapies have led to more effective treatments for various cancers and other diseases, such as cystic fibrosis. The Food and Drug Administration has approved a growing number of specialized drugs for patients with specific genetic mutations, and the biotech industry has many more drugs in development. The trend has benefited from sharp declines in the cost of genome sequencing. (Dennis, 1/29)

Politico: Obama’s ‘Precision Medicine’ Initiative Could Bring Insight Into Disease

The White House on Friday unveiled a $215 million program to study genes of a million Americans in various stages of sickness and health, with the hope of gaining vast new insight into diseases and how to cure them. (Allen, 1/30)

NBC News: Obama Seeks Millions for 'Precision Medicine'

President Barack Obama is asking Congress for $215 million to pay for what he's calling a Precision Medicine Initiative — a plan to rev up more targeted treatments for people. The hope is to build on gains like those made recently in treating cancer. Scientists know that cancer isn't just a single disease and it's become clear that even specific types of cancer, such as breast cancer, are truly separate diseases with separate causes. The initiative would aim to take these discoveries across medicine. (Fox, 1/30)

The Boston Globe: Obama ‘Precision Medicine’ Plan Would Be Boon To Mass.

The Massachusetts life sciences sector, a world leader in developing gene-based therapies and diagnostics, is ready to capitalize on a new program proposed by President Obama to invest in medical research into treatments tailored to an individual’s genes. (Newsham, 1/30)

Health Law

States Continue -- In Fits And Starts -- To Contemplate Medicaid Expansion

News outlets report on the latest developments in Missouri, Tennessee, Ohio and Iowa.
The St. Louis Post-Dispatch: More Governors Embrace Medicaid Expansion, But With Changes

When Indiana became the latest state to expand its Medicaid program, the reaction across the health advocacy community was decidedly mixed. While the decision represented yet another step toward a goal of expanding government-funded health insurance to millions of lower-income Americans, it came at a price — one some advocates say may be too expensive to pay. (Shapiro, 2/2)

St. Louis Public Radio: Despite Odds, Advocates Push For Medicaid Expansion

Advocates continue to push for the expansion of Medicaid to include Missourians who fall in the so-called “coverage gap.” State legislators have made it clear that expansion is unlikely to happen this year either. But Medicaid advocate Richard von Glahn remains optimistic. (Phillips, 2/1)

The Associated Press: Special Session On Insure Tennessee Gets Underway Monday

Lawmakers convene a special session Monday to take up Republican Gov. Bill Haslam's proposal to extend health coverage to 280,000 low-income Tennesseans. The proposal is simple, but the politics are not. Haslam's plan is a two-year pilot project called Insure Tennessee. The deal calls on state hospitals to pay the $74 million state share to draw down $2.8 billion dollars in federal Medicaid money to offer coverage to uninsured Tennesseans. (Schelzig, 2/2)

The Des Moines Register: Some Iowans Will Face Premiums For Medicaid Expansion

As Iowa's modified Medicaid expansion hits the one-year anniversary mark, some enrollees will be asked to pay small monthly premiums because they have not yet completed a required physical exam and health questionnaire. For Gov. Terry Branstad, setting these health requirements was a key provision for expanding Medicaid in Iowa using funding from President Barack Obama's health care overhaul. The state received federal approval to make modifications to the traditional Medicaid terms, including setting health requirements and charging contributions. (Lucey, 2/1)

Columbia Dispatch: Ohio Legislature Might Avoid Voting On Keeping Medicaid Expansion

The much-anticipated debate over whether to continue Gov. John Kasich’s expansion of Medicaid through the next two-year state budget might be over before it starts. Kasich’s proposed two-year spending plan, to be unveiled today, won’t seek to reauthorize expanded eligibility guidelines that took effect last year and added 450,000 poor adults to the tax-funded health-care rolls. That doesn’t mean the governor no longer supports Medicaid expansion; he does, and he also wants to make changes to the program to save money and promote personal responsibility. But administration sources say they don’t believe lawmakers must reauthorize expansion because it is already in state law and remains so unless it is revoked. (Candisky, 2/2)

The Washington Examiner: More States Look To Expand Medicaid

As Indiana won federal approval to move ahead with its version of Medicaid expansion, other Republican-governed states are lining up with their sketchbooks in hand. (Winfield Cunningham, 2/1)

Minn. Lawmakers Want A More Accountable Health Exchange

One proposal would dissolve MNsure's board, put a commissioner in charge and have it run like any other executive department. Meanwhile, Connecticut's exchange has been unable to mail tax forms to about 3,600 customers and Oregonians are warned of the Feb. 15 enrollment deadline.
Minnesota Public Radio: Department Of MNsure? Lawmakers Want Health Exchange More Accountable

DFL state Sen. Tony Lourey stood next to Gov. Mark Dayton two years ago as he signed legislation creating MNsure. Now, Lourey's ready to remake the health exchange's structure. ... after a troubled 16 months operating, Lourey wants more accountability. His bill would dissolve MNsure's board, put a commissioner in charge and have it run like other executive branch departments. (Richert, 2/1)

Connecticut Mirror: Key Tax Forms Delayed For 3,600 Connecticut Obamacare Customers

Connecticut’s health insurance exchange has delayed mailing 3,600 customers the forms they will need to file their tax returns, and might not get them out until the end of next month. (Levin Becker, 1/30)

The Oregonian: Oregonians Have Two Weeks To Get Health Coverage Or Risk A Tax Penalty

Oregonians have just two weeks left to sign up for health insurance as required under federal law or face a potential fine at tax time next year. (Budnick, 2/1)

Kaiser Health News: Why Florida Is No. 1 In Obamacare Enrollment Despite GOP Opposition

When Florida workers promoting President Barack Obama’s health law marketplace want instant feedback, they go to an online “heat map.” The map turns darker green where they’ve seen the most people and shows bright red dots for areas where enrollment is high. “The map shows us where the holes are” and what communities need to be targeted next, said Lynn Thorp, regional director of the Health Planning Council of Southwest Florida. She hands out information about the health law’s marketplace at rodeos, farmers markets, hockey games —almost any place where people gather. (Galewitz, 2/2)

Making Too Much For Medicaid, Some Choose More Work To Get Subsidies

A quirk of the health law sometimes means people who make too much money to qualify for Medicaid also make too little to qualify for federal insurance subsidies. Also in the news coverage about the law, at the White House, worries build over Americans' health law anger during tax season.
The New York Times: Piling On Work To Escape Gap In Health Law

Alma Ramos, a soft-spoken prep cook at a Tex-Mex restaurant, was eager to sign up for health insurance through the new healthcare.gov marketplace last year. But Ms. Ramos, a single mother of three, quickly hit a baffling hurdle. Because of a wrinkle in the Affordable Care Act, Ms. Ramos made too little money to receive federal aid for buying private insurance — and too much to qualify for Medicaid, the government health care program for the poor. But she found a solution. (Goodnough, 2/1)

The New York Times: White House Seeks To Limit Health Law’s Tax Troubles

Obama administration officials and other supporters of the Affordable Care Act say they worry that the tax-filing season will generate new anger as uninsured consumers learn that they must pay tax penalties and as many people struggle with complex forms needed to justify tax credits they received in 2014 to pay for health insurance. The White House has already granted some exemptions and is considering more to avoid a political firestorm. (Pear, 1/30)

Health IT

HHS Pushes Information Sharing For Electronic Health Record Systems

The Obama administration released a draft plan requiring most providers to adhere to information-sharing standards by the end of 2017. Meanwhile, a report by congressional staffers contends that companies such as Google, Twitter and Yahoo are grabbing data from consumers when they use healthcare.gov.
Reuters: U.S. Releases Draft Plan For Electronic Health Data

The Obama administration on Friday proposed a plan to move most doctors, hospitals and their patients to national standards for handling electronic clinical data by the end of 2017. The U.S. Department of Health and Human Services (HHS), as part of an effort to propel the $2.9 trillion U.S. health care system away from a costly fee-for-service system, released a report draft aimed at establishing an interoperable health information technology system that can be accessed by patients and their health care providers. (1/30)

The Hill: Google, Twitter, Yahoo Nab Healthcare.gov Data

Companies including Google, Twitter, Yahoo and Advertising.com automatically obtain information from people visiting HealthCare.gov, according to analysis by congressional staffers. The finding builds on news last week that dozens of data-tracking companies were able to obtain information about people visiting the federal healthcare website, potentially including information about their age, location and pregnancy status. (Hattem, 1/30)

Public Health

Efforts To Contain Measles Outbreak Involve Infection Control Expertise And Detective Work

Health officials work to track measles patients in order to identify people who may have come into contact with them and therefore may be at risk. In some cases, parents are being advised to keep babies who may have been exposed at home for 21 days. Meanwhile, parents who have opted not to vaccinate their children are defending this choice.
Los Angeles Times: In The Fight Against Measles, Science And Detective Work Join Forces

The battle to halt the spread of the measles outbreak that began at Disneyland has required both infectious disease expertise and a good amount of old-fashioned detective work. Health officials in California and seven other states have painstakingly traced the steps of measles patients, tried to identify anyone who came in contact with them, and quarantined those at greatest risk of getting the highly contagious disease to keep the virus from spreading. (Xia, Lin II and Muskal, 1/30)

NPR: As Measles Outbreak Spreads, Some Babies Under Isolation

California is grappling with an outbreak of measles. In Alameda County, health officials have told parents whose babies have been exposed to the virus to keep their children at home for 21 days. (Neighmond, 2/2)

The New York Times: Vaccine Critics Turn Defensive Over Measles

Their children have been sent home from school. Their families are barred from birthday parties and neighborhood play dates. Online, people call them negligent and criminal. And as officials in 14 states grapple to contain a spreading measles outbreak that began near here at Disneyland, the parents at the heart of America’s anti-vaccine movement are being blamed for incubating an otherwise preventable public-health crisis. Measles anxiety rippled thousands of miles beyond its center on Friday as officials scrambled to try to contain a wider spread of the highly contagious disease — which America declared vanquished 15 years ago, before a statistically significant number of parents started refusing to vaccinate their children. (Healy and Paulson, 1/30)

State Watch

State Highlights: Sutter, Blue Shield Resolve Calif. Health Care Contract Dispute; Hawaiian Health Workers Start 6-Day Strike

A selection of health policy stories from California, Hawaii, Colorado, Iowa, Kansas, Minnesota and Virginia.
San Jose Mercury News: Sutter Health, Blue Shield Reach Two-Year Agreement

Ending a monthlong standoff that rattled 284,000 health care consumers, Blue Shield of California and Sutter Health on Friday announced they had reached an agreement for a new two-year contract that will allow the insurer's patients to continue to use Sutter doctors and hospitals. (Seipel, 1/30)

The Associated Press: California Health Care Contract Fight Resolved

Health insurance provider Blue Shield of California and the Sutter Health network of doctors and hospitals have reached agreement on a new contract, ending a dispute that threatened to force nearly 280,000 consumers in Northern and Central California to find new doctors. The companies announced the two-year contract on Friday. It means Blue Shield patients will be able to continue using Sutter doctors and hospitals without going out of their coverage network. (1/31)

The Associated Press: Kaiser Permanente Workers In Hawaii Begin 6-day Strike

Workers at Hawaii's largest health care organization started a six-day strike early Monday, union spokeswoman Paola Rodelas said. Licensed practical nurses, medical assistants and housekeepers were among those joining the work stoppage at Kaiser Permanente. The strike will last through Saturday. (2/2)

Bay Area News Group: Hospitals' Dumping Of Drunk Patients Would Be Barred By Controversial California Bill

Hospitals that refuse to treat severely intoxicated patients and instead have them arrested would face steep fines of up to $300,000 per incident under a controversial bill unveiled Friday. (Calefati, 1/30)

Los Angeles Times: Hospital Chain Prime Healthcare Faces A Fight To Grow

Buried in debt, Centinela hospital of Inglewood was on the verge of bankruptcy in 2007. It had lost $50 million in four years, and local officials worried that it might close — following the path of several other South Los Angeles hospitals. But where others saw risk, cardiologist Prem Reddy saw opportunity. Reddy's company, Prime Healthcare Services Inc., bought Centinela and quickly turned it around, cutting expenses and increasing revenue. Centinela lost $63 million in 2007. Six years later, it made $39 million. Today it's rated among the better-performing hospitals in the state. (Pfeifer, 2/1)

Los Angeles Times: California Stumbles At Shifting Care For Costly Patients

California's ambitious effort to save billions of dollars by changing how the state's costliest patients get treated is on the ropes. The Obamacare program was designed to reduce medical costs by putting more of the nation's 11 million most challenging and expensive patients into tightly managed care. But the rollout in California — one of the first states spearheading the effort — has been marred by widespread confusion, enrollment glitches and a revolving door of health officials. (Terhune, 1/31)

The Denver Post: Colorado Hospitals Win, Lose In Medicare Reform Sweepstakes

Under health care reform, Medicare bonuses are going to hospitals that are getting things right, at least from the federal governments perspective. Medicare data shows 1,700 hospitals, more than half graded, will reap extra payment in 2015. In Colorado, where 44 hospitals participated in the program, 57 percent received bonuses, or increased Medicare payments in 2015, while 43 percent will have penalties, or reduced payments. None broke even. (Draper, 1/30)

The Des Moines Register: Community Slams Plan To Close Mental Hospital

State administrators are wrong when they say many patients at the state psychiatric hospital here could obtain similar services from private agencies in southern Iowa communities, mental-health professionals and patients alleged Saturday. Department of Human Services Director Charles Palmer told the crowd that new mental health treatment options are being considered as part of the statewide redesign of the overall system. He explained that new regional authorities, including the one that covers the Clarinda area, are considering opening short-term "crisis centers" or "step-down units." (Leys, 1/31)

The Kansas Health Institute News Service: Nursing Practice Bill Heats Up In Kansas

Groups representing nurses and doctors met several times over the summer and fall but couldn’t reach a compromise on legislation to allow nurses with advanced training to practice on their own. The failed negotiations threw the dispute back into the laps of Kansas lawmakers, who don’t appear eager to settle it. (McLean, 1/30)

The Associated Press: At Capitol, Plans Abound For Addressing Rural Health Care

Bob Jeske grew up on a farm and always wanted to practice rural medicine. But it didn't hurt that a state program covered some of his student loans to do just that. State lawmakers in both parties want to expand the program that takes a big chunk out of Jeske's $182,500 in medical school debt. Their plan is one of many approaches to solving a looming shortage of doctors and other health care professionals expected to hit hardest in rural Minnesota. (Farhang, 2/2)

The Denver Post: Proposal Seeks $5M To Give Contraceptives To Colorado Teens

A bipartisan proposal would seek $5 million of state funds to continue giving intrauterine contraceptive devices to teenagers, a program state officials say has dramatically reduced the teen birth rate. The proposed bill is one of two legislative measures aimed at preventing teen pregnancies in Colorado. The other, already introduced, would expand a pilot education program. (Draper, 1/30)

The Washington Post: She Fought For Patients’ Rights, Then She Was Put In A Hospital Against Her Will

[Alison] Hymes was no ordinary patient. Before landing at Western, she spent years urging others with mental illness and their families not to let doctors, judges and social workers make decisions for them. She was part of a state task force charged with reforming civil commitment laws at the time of the 2007 Virginia Tech massacre, serving alongside doctors, academics, and law enforcement officials. The daughter of a prominent University of Virginia linguist, Hymes argued vehemently — and unsuccessfully — against loosening the state’s commitment criteria. Hymes, now 58, believed those changes made it easier for authorities to involuntarily commit her in 2011 and again in 2013. (Shin, 1/31)

Kaiser Health News: California Ranks Last In Spending On Diabetes Prevention, Audit Finds

Reporting for Kaiser Health News, Barbara Feder Ostrov writes: "California spends less per person than any state on diabetes prevention programs, even as one in 12 California adults is estimated to suffer from the chronic disease, according to a new report from the California State Auditor. Using only federal grants, California spent just 3 cents per person on diabetes prevention in the 2012-2013 fiscal year, compared to New York’s 42 cents per person in state and federal money that year, the report noted." (Ostrov, 2/2)

The New York Times: Medical Costs Rise As Retirees Winter In South

Like many retirees, one couple from upstate New York visit doctors in their winter getaway in Florida. But on a recent routine checkup of a pacemaker, a cardiologist there insisted on scheduling several expensive tests even though the 91-year-old husband had no symptoms. ... The couple’s experience reflects a trend that has prompted some doctors up north to warn their older patients before they depart for Florida and other winter getaways to check in before agreeing to undergo exams and procedures. And some patients have learned to be leery after being subjected to tests — and expenses — that long-trusted physicians at home never suggested. (Rosenthal, 1/31)

Editorials And Opinions

Viewpoints: 'Lunacy' In Vaccine Views; Jindal Blasts Some Health Law Replacement Efforts

A selection of opinions on health care from around the country.
The New York Times: The Vaccine Lunacy

It used to be that unvaccinated children in America were clustered in impoverished neighborhoods; now they’re often clustered among sophisticates in gilded ZIP codes where a certain strain of health faddishness reigns. According to a story in The Hollywood Reporter last year, the parents of 57 percent of the children at a Beverly Hills preschool and of 68 percent at one in Santa Monica had filed personal-belief exemptions from having their kids vaccinated. Why? Many of them buy into a discredited theory that there’s a link between the MMR (mumps-measles-rubella) vaccine and autism. (Frank Bruni, 1/31)

The Washington Post: The Measles Vaccine Is A Shot Of Common Sense

Is measles “benign”? The Centers for Disease Control and Prevention says measles “can lead to severe complications and death” and “even patients who experience uncomplicated acute measles have a small risk for developing a devastating neurologic illness . . . years after their infection.” Measles is common elsewhere in the world, with about 20 million cases reported each year and 122,000 deaths. Before vaccination began in 1963, about 3 million to 4 million people got the disease each year in the United States, of whom 400 to 500 died, 48,000 were hospitalized and 4,000 developed brain swelling. That does not fit our definition of benign. (1/31)

Politico: The GOP Mustn’t Offer Obamacare Lite

There is a secret that people outside of Washington, D.C., aren’t aware of right now: Some Republicans in Congress are on the verge of proposing an alternative to Obamacare that imposes new tax hikes on the American people. ... The reality is that while Beltway insiders in the elite salons of Washington can do and say whatever they want, the American people know better. A majority of voters — and even larger majorities of conservative and Republican voters — believe that “any replacement of Obamacare must repeal all of the Obamacare taxes and not just replace them with other taxes.” In other words, the voters won’t be fooled by quasi-liberal health plans masquerading in conservative clothing. (La. Gov. Bobby Jindal, 2/1)

The New York Times: Onward, Christian Health Care?

Regulators in several states have raised concerns that these ministries offer the illusion of insurance while sidestepping the Affordable Care Act’s baseline standards of coverage and skirting requirements that apply to conventional insurance companies, like minimum cash reserves. Nonetheless, membership in the ministries has been growing, particularly since the act granted them an exemption as one of the only ways to avoid the law’s mandate to buy insurance without paying a fine. But the debate over consumer protections may disguise a more interesting question: Could this model scale up? These ministries seem to achieve a remarkable level of member satisfaction, even if they sometimes must portion out reimbursements when the bills outstrip monthly contributions. (Molly Worthen, 1/31)

The Wall Street Journal's Washington Wire: What Is Government’s Role In Comparing Medical Treatments?

The personalized medicine initiative that President Barack Obama announced on Friday was previewed in the State of the Union address and is scheduled for inclusion in the budget to be released Monday. But in devoting federal funds to this, the administration may have made an argument against another type of medical research funded as part of Obamacare. (Chris Jacobs, 2/1)

The Wall Street Journal: Tennessee’s Plan To Expand Medicaid Doesn’t Add Up

Gov. Bill Haslam ... announced right before Christmas that he had a verbal commitment from the Obama administration to expand Medicaid subject to some changes. But Mr. Haslam’s announcement was only the first step. Thanks to a law passed last year, Tennessee lawmakers must sign off on any expansion of Medicaid. ... Tennessee lawmakers must decide if they are going to burden more state residents—and American taxpayers—with ObamaCare’s broken promises, failed schemes and unsustainable policies, or whether their state will lead the march toward more freedom, greater access, and better health outcomes. With several other red states including Utah, Wyoming and Montana waiting in the wings on Medicaid expansion, what Tennessee does next week could have implications far beyond the state’s borders. (Christie Herrera and Justin Owen, 1/30)

Montana Standard: Business, Financial Benefits Of Medicaid Expansion 'Remarkable'

The Montana Legislature has the opportunity to do more good for our state at less cost than will be available for decades. All we need to do is accept funds to which our citizens are entitled through Medicaid expansion to establish a Montana-based privately run health insurance program. As a 30-year investment professional, I find the business and financial benefits of expansion to be remarkable. Much attention has been focused on the 70,000 Montanans who would be provided healthcare coverage. Largely overlooked in the discussion is the fact that all Montanans will benefit through a stronger economy, substantial job creation, a more secure healthcare system, and a reduction in the costs we all pay to care for the uninsured. (Mark Semmens, 2/1)

The Washington Post: Reasonable Reforms To Military Retiree Health Benefits Are Needed

The Pentagon budget is $496 billion, which sounds like a lot of money, and it is — until you take account of the fact that an increasing share goes not for weapons, training and readiness but for health care and pension benefits of former service members. ... Now comes the Military Compensation and Retirement Modernization Commission, a blue-ribbon panel established by Congress in 2013, with the latest package of proposed reforms. The panel has clearly done its homework, as demonstrated by the sheer mass of its 302-page report. In one respect, however, its work disappoints: The panel recommends no change to the so-called Tricare for Life program, essentially a free Medigap plan for military retirees age 65 and older that the CBO has repeatedly identified as a major cost center — and which is all but untouchable politically. ... More encouraging was the commission’s proposal to revamp the versions of Tricare that apply to the families of active-duty personnel and working-age retirees. (1/30)

The New York Times: Forty Years Of Servitude, And Counting

An enduring injustice was supposed to end on Jan. 1. That was the effective date for new rules by the Labor Department that would have required employers of home care aides for the elderly and disabled to pay at least the federal minimum wage and time and a half for overtime. Specifically, the new rules would have ended a federal regulation from 1974 that labeled home care aides “companions,” a designation that lets their employers — generally, for-profit agencies — ignore basic labor protections. (1/31)

The New York Times: Don't Trade Away Our Health

Representatives from the United States and 11 other Pacific Rim countries convened to decide the future of their trade relations in the so-called Trans-Pacific Partnership (T.P.P.). Powerful companies appear to have been given influence over the proceedings, even as full access is withheld from many government officials from the partnership countries. Among the topics negotiators have considered are some of the most contentious T.P.P. provisions — those relating to intellectual property rights. And we’re not talking just about music downloads and pirated DVDs. These rules could help big pharmaceutical companies maintain or increase their monopoly profits on brand-name drugs. (Joseph E. Stiglitz, 1/30)

The New York Times: Dying Shouldn’t Be So Brutal

Michael was receiving state-of-the-art treatments at a renowned cancer center in New York City. As he became sicker, the treatments got more intense. Each decision came with more difficult trade-offs and uncertainties. Each step to stay alive risked making things worse. He knew it. We’d talked openly about it. His life was precious and worth fighting for, so every option was worth carefully considering. But modern medicine has yet to make even one person immortal. Therefore, at some point, more treatment does not equal better care. (Ira Byock, 1/31)

The New York Times: The Long-Run Cop-Out

Think about it: Faced with mass unemployment and the enormous waste it entails, for years the Beltway elite devoted almost all their energy not to promoting recovery, but to Bowles-Simpsonism — to devising “grand bargains” that would address the supposedly urgent problem of how we’ll pay for Social Security and Medicare a couple of decades from now. (Paul Krugman, 2/2)

The New York Times: Live, From The Nursing Home

Donald Hall, 86, a former poet laureate, probably captured the general mood when he wrote that nursing homes are “old-folks storage bins” and “for-profit-making expiration dormitories.” He wants to die in his farmhouse in New Hampshire. But I think that sounds pretty lonely. I wouldn’t mind going into a nursing home and not coming out. In due time, thank you. I’m 64. (Bert Stratton, 2/2)

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