- KFF Health News Original Stories 3
- An Obamacare Payment Reform Success Story – One Health System, Two Procedures
- More Evidence That Health Plans Stint On Mandated Birth Control Coverage
- Montana Governor Signs Medicaid Expansion Into Law
- Political Cartoon: ‘Lay The Blame?’
- Capitol Watch 3
- GOP Lawmakers Agree On Blending House And Senate Budget Blueprints
- Republicans Divided On Response If High Court Voids Obamacare Subsidies
- House Leaders Unveil New Bill To Speed Drugs To Market
- Health Law 3
- Red States Increasingly Seek Work Requirements As Part Of Medicaid Expansion Efforts
- Insurers Violate Health Law's Protections For Women, Studies Find
- Auditor: States Might Be Propping Up Exchanges Illegally
- State Watch 5
- Hospitals Prove Their Importance In Rural Towns
- R.I. Wrestles With Ways To Reduce State's Medicaid Costs
- Texas, Ala. Consider Further Abortion Restrictions
- In Third Attempt, N.C. Senate Passes Autism Coverage Bill
- State Highlights: N.C. Bill Would Forbid Asking Patients About Firearms; Calif. Individual Insurance Market Up 64%
From KFF Health News - Latest Stories:
KFF Health News Original Stories
An Obamacare Payment Reform Success Story – One Health System, Two Procedures
As part of an experiment run by the Centers for Medicare and Medicaid Innovation, doctors, nurses and managers at Baptist Health System in San Antonio joined forces to cut costs for hip and knee replacements, getting patients on their feet sooner, saving taxpayers money and increasing their own earnings. (Jay Hancock, )
More Evidence That Health Plans Stint On Mandated Birth Control Coverage
Researchers with the National Women’s Law Center find insurers around the country are failing to provide contraception and other care without copays. (Julie Rovner, )
Montana Governor Signs Medicaid Expansion Into Law
Backers of Medicaid expansion celebrated in Helena as Gov. Steve Bullock signed the bill extending the health coverage to an estimated 45,000 more Montanans. (Eric Whitney, Montana Public Radio, )
Political Cartoon: ‘Lay The Blame?’
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: ‘Lay The Blame?’" by Steve Kelley, The Times-Picayune.
Here's today's health policy haiku:
A DIFFICULT COST-BENEFIT ANALYSIS
Specialty drug costs
At what price a remedy?
Painful decisions.
- Anonymous
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:
GOP Lawmakers Agree On Blending House And Senate Budget Blueprints
The non-binding budget resolution will set up flash points with the Obama administration over a range of issues, including the health law, the health care safety net and spending on domestic programs.
The Associated Press:
GOP Unveils Budget Plans In Face Of Obama Opposition
Republicans controlling Congress Wednesday unveiled a budget plan for the upcoming year and beyond, setting up a confrontation with President Barack Obama over his signature health care law and his vow to boost spending on domestic programs like transportation and education. House-Senate negotiators on the sweeping — but nonbinding — budget plan sealed agreement Wednesday. The 10-year balanced budget plan calls upon lawmakers to repeal Obama's health care law while enacting major curbs on safety net programs like Medicaid and food stamps. It would cut future-year budgets for domestic agencies below already tight spending "caps" that the White House vows to dismantle. (4/29)
The Wall Street Journal:
U.S. House And Senate Republicans Agree On Combined Budget
If it passes, the budget resolution will also unlock a procedural tool that Republicans say they will use to send the White House a repeal of Mr. Obama’s health-care law. That tool, known as “reconciliation,” allows legislation to pass Congress with a simple majority. Republicans control 54 of 100 seats in the Senate, where most bills require 60 votes to avoid procedural hurdles. (Timiraos and Peterson, 4/29)
The Washington Post:
Republicans Reach Budget Deal, Take Aim At Obamacare
The Republican budget ignores Obama’s threat to veto any funding bills that lock in spending cuts for domestic programs. Instead negotiators opted for deep domestic cuts, nearly $40 billion in additional defense spending from off-book funds and a new attack on the president’s signature health-care bill. (Snell, 4/29)
Reuters:
Republican Budget Seeks To Boost Defense Spending, Ease Repeal Of Obamacare
[T]he "reconciliation" procedural instructions are focused exclusively on repealing Obamacare, the five-year-old Affordable Care Act. The document directs the two Senate committees and three House committees with jurisdiction over the law to find savings of at least $1 billion each. (Lawder, 4/29)
Politico:
Corker Relents, Handing GOP A Budget Victory
Under intense pressure from his Republican colleagues, Sen. Bob Corker on Wednesday dropped objections to what he called gimmickry in a budget deal, paving the way for Congress to clear a spending blueprint for the first time in half a decade. The Tennessee Republican’s concession represents a major victory for GOP leadership, Republican moderates and defense hawks. Had Corker succeeded, appropriators say they would have had to cut several billion dollars from domestic programs when there’s precious little money to spare. (Bade, 4/29)
Meanwhile, a new poll offers insights about what voters think of some of the programs subjected to GOP budget cuts or changes -
Reuters:
Americans Don't Like Big Government - But Like Many Programs: Poll
Conservative presidential candidates hitting the 2016 campaign trail are firing up crowds with calls to shrink the U.S. government, but a new poll shows that Republican voters who rally to that cry still want to maintain many federal programs. Ideas such as abolishing the U.S. income tax and shifting many of the federal government's responsibilities to the states draw robust support from Republican voters, according to a Reuters/Ipsos poll. But there is much weaker support for curbing government’s role in providing a social safety net and for curbing some of its regulatory functions. ... Nearly 80 percent of Republicans oppose eliminating middle-class entitlement programs such as Social Security and Medicare. Sixty-four percent of Republicans oppose getting rid of aid programs for the poor, such as food stamps and Medicaid. (Becker, 4/30)
Republicans Divided On Response If High Court Voids Obamacare Subsidies
GOP lawmakers have yet to unite behind a single strategy if the Supreme Court overturns the health law's insurance subsidies in about three dozen states. Most of the proposals being considered, however, would put off the pain of millions of Americans losing their subsidies until after the 2016 elections. The justices are expected to rule in June.
The Associated Press:
GOP Divided As Supreme Court Ruling On Health Care Law Nears
Congressional Republicans are divided over how to respond to an approaching Supreme Court decision on President Barack Obama's health care law, even as growing numbers concede that their long-sought goal of repealing the statute will have to wait. Should the plaintiffs prevail in the GOP-backed lawsuit, the justices could annul one of the law's backbones: federal subsidies helping around 7.7 million people afford health insurance in more than 30 states. Republicans broadly agree that Congress should react by temporarily replacing that aid, aware that abruptly ending it would anger millions of voters before the 2016 presidential and congressional elections. (Fram, 4/30)
The Associated Press:
GOP Plans For Reacting To Supreme Court Ruling On Health Law
Congressional Republicans have yet to unite behind any of the growing number of proposals for responding to a Supreme Court ruling that could void federal subsidies that millions of people use to buy coverage under President Barack Obama's health care law. The decision is expected by June. (4/30)
Modern Healthcare:
Republicans Jockey Over Post-King Reform Plans
Facing sharp disagreements among themselves, congressional Republicans are nervously wrestling with how to respond if the U.S. Supreme Court in June strikes down premium subsidies in up to 37 states. There are at least five different proposals from Senate and House Republicans, and they differ considerably in scope. But all seem intended to put off or limit the pain of Americans losing their subsidies and coverage until after the 2016 elections. It's highly uncertain whether Republicans can unite behind a single plan, given that more conservative Republicans oppose any federal funding or regulatory role in expanding health coverage. And in the wake of a Supreme Court ruling in King v. Burwell striking down subsidies, any proposal that offers any subsidies could be scored by Congressional Budget Office as new spending. (Demko, 4/29)
House Leaders Unveil New Bill To Speed Drugs To Market
The legislation, known as the 21st Century Cures bill, also overhauls the Food and Drug Administration and the National Institutes of Health, boosting funding for the latter.
The Hill:
Landmark Overhaul Of Drug Research Is Proposed In The House
Leaders of the House Energy and Commerce Committee on Wednesday unveiled a long-awaited draft of legislation that would speed up the approval of new drugs and treatments. The bipartisan, multi-billion dollar initiative, known as 21st Century Cures, includes major overhauls of the Food and Drug Administration (FDA) as well as the National Institutes of Health (NIH). (Ferris, 4/29)
Modern Healthcare:
New Draft Of Medical Innovation Bill Boosts NIH Funding
A new draft of House legislation that creates significant new regulatory leeway for drug and device companies includes more funding for the National Institutes of Health, representing a compromise with Democrats who withdrew support for the bill. Leaders of the House Energy & Commerce Committee are circulating a new “discussion draft” of the 21st Century Cures bill that would raise NIH funding to $31.8 billion in fiscal 2016 and to $34.85 billion in fiscal 2018. Congress appropriated $30.3 billion for the NIH in fiscal 2015, and President Barack Obama requested $31.3 billion for fiscal 2016. (Tahir, 4/29)
Red States Increasingly Seek Work Requirements As Part Of Medicaid Expansion Efforts
The efforts, however, are not winning support in the Obama administration. Meanwhile, Montana's governor signs the state's expansion bill and Florida legislature is still at an impasse over the issue.
Politico:
GOP Warms To Obamacare — If Americans Work For It
In nearly a dozen Republican-dominated states, either the governor or conservative legislators are seeking to add work requirements to Obamacare Medicaid expansion, much like an earlier generation pushed for welfare to work. The move presents a politically acceptable way for conservative states to accept the billions of federal dollars available under Obamacare, bringing health care coverage to millions of low-income people. But to the Obama administration, a work requirement is a non-starter, an unacceptable ideological shift in the 50-year-old Medicaid program and a break with the Affordable Care Act’s mission of expanding health care coverage to all Americans. The Health and Human Services Department has rejected all requests by states to tie Medicaid to work. (Wheaton, 4/30)
The Associated Press:
Bullock Signs Medicaid Expansion Into Law
After several years and a long bumpy road to passage, the governor signed a bill into law Wednesday to expand Medicaid eligibility to about 70,000 low-income Montanans. ... The compromise proposal was introduced by Republican Sen. Ed Buttrey of Great Falls in March after lawmakers defeated Bullock's plan. The new law would accept federal funds to expand Medicaid eligibility to people with incomes at or below 138 percent of the federal poverty level — or about $16,200 per year for an individual and $33,460 for a family of four. It also would require people who enroll in the program to pay health care premiums and co-payments for certain services. Additionally, all those who choose to enroll would be asked by the state Department of Labor to participate in a workplace assessment survey for the creation of a job placement plan that could include training. (Baumann, 4/29)
Helena (Mont.) Independent Record:
Medicaid Expansion Is Now Law In Montana – But Still Many Steps Before It Becomes Reality
Now that Medicaid expansion is law in Montana, the real work of making it happen begins -- and state health officials said Wednesday it certainly won’t happen overnight. The state first must prepare and submit a “waiver” for approval by the federal government, before Montana’s plan to expand Medicaid to thousands of low-income Montanans can begin and be funded. And, if that approval occurs, the state then must hire a private health-insurance company to manage the expansion, choosing from whoever decides to bid on the multimillion-dollar contract. (Dennison, 4/29)
Great Falls (Mont.) Tribune:
'Great Falls Kept Fighting' For Medicaid Expansion
Buttrey said he spent the two years since the last session, which saw Medicaid expansion defeated, educating his caucus and trying to craft a plan that would pass. "We came armed with facts and armed with a plan," he said. "Folks already have a health care entitlement. They're just getting it in the most expensive way," he said of emergency room care. He said the states already are paying for expansion, with Montana tax dollars now going to subsidize expansion in other states. (Inbody, 4/29)
Kaiser Health News/Montana Public Radio:
Montana Governor Signs Medicaid Expansion Into Law
Backers of Medicaid expansion celebrated in Helena Wednesday as Gov. Steve Bullock signed the bill extending the health coverage to an estimated 45,000 more Montanans. Earl Old Person, Chief of the Blackfeet tribe, sang a victory song on the capitol steps honoring the Governor and lawmakers who passed the Medicaid expansion bill. (Whitney, 4/30)
Tampa Bay Times/Miami Herald:
Senate Accuses House Of Violating Constitution, Demands Return To Session Friday
The Florida Legislature’s chaotic session hit a new dysfunctional low Wednesday as an irate Senate demanded that House leaders bring lawmakers back to work or risk violating the state Constitution. House Speaker Steve Crisafulli, R-Merritt Island, who had sent members home Tuesday, showed no signs of backing down. With increased vitriol on both sides, it appeared less likely than ever the House and Senate could come together for critical budget talks. ... the two sides remain locked in an increasingly bitter stalemate, unable to begin budget talks because of a philosophical divide over the use of federal money to expand health care to low-income residents. (Bousquet, 4/29)
The Associated Press:
Obama Administration Hasn't Changed Course On LIP, Medicaid
The Obama administration said Wednesday it had not changed its position on Medicaid expansion and hospital funds, despite contrary interpretations from lawmakers. The confusion comes a day after Gov. Rick Scott filed a federal lawsuit accusing the Obama administration of coercing Florida into expanding Medicaid by withholding more than $1 billion in hospital funds. (Kennedy, 4/29)
Miami Herald:
Florida House Says It Is Ready To Build A Budget
One day after abruptly ending the legislative session, the House announced it is ready to begin the budget process. The announcement from House Speaker Steve Crisafulli, R-Orlando, came in response to a late statement issued by the Centers for Medicare and Medicaid Services, or CMS. "Last night, after Gov. [Rick] Scott and Attorney General [Pam] Bondi filed a lawsuit on behalf of Florida, CMS issued a statement reversing their earlier position that [Low Income Pool] funding and Medicaid Expansion are linked," Criasfulli wrote in a Wednesday morning memo to members. "We applaud CMS for their statement, and agree that the policy preference of the Obama administration should not be used as leverage for the Low Income Pool. The House stands ready to secure allocations and get into budget conference in order to finish our constitutional duty to pass a balanced budget." (McGrory, 4/29)
Miami Herald:
Could Medicaid Expansion Debacle Be An Opening For House Democrats?
It's good to be a Florida House Democrat these days. Just six months ago, they were in the doldrums. They had lost six seats in the November elections and were facing an 81-39 disadvantage in the lower chamber. But on Wednesday, the Democrats were in a more celebratory mood. The day before, House Speaker Steve Crisafulli, R-Merritt Island, told members to go home. The budget impasse was too broad to bridge because of the House's disagreement with the Senate on Medicaid expansion. The House Democrats have been pushing for Medicaid expansion for three years now. The stalemate between the House Republicans and the Senate on the budget guaranteed exactly what House Democrats couldn't do: force a meaningful debate. (Van Sickler, 4/29)
Also in the news, Utah officials complete their talks with federal authorities and say they still have some work to do on their expansion proposal. In Louisiana, lawmakers turn down expansion efforts again -
The Associated Press:
Utah Group Leaves Washington, But No Medicaid Deal Yet
Gov. Gary Herbert and Republican legislative leaders said they were optimistic Wednesday after leaving a meeting in Washington with federal officials, but they're still without a deal or new flexibility to expand Medicaid in Utah. The group said they still hope to reach a deal this summer. Following their meeting with U.S. Health and Human Services Secretary Sylvia Burwell, Herbert and GOP lawmakers held a teleconference with reporters. They said they have agreed to examine ways that Utah can more accurately project how much it will cost to expand Medicaid. (Price, 4/30)
Salt Lake Tribune:
Guv, Legislative Leaders Meet With Obama Administrators On Utah Health Care
Utah legislative leaders and the governor were optimistic they will be able to reach a compromise on Medicaid expansion after their first joint meeting Wednesday with U.S. Health and Human Services Secretary Sylvia Burwell. "I thought there was a great response from the secretary and her staff," said Senate President Wayne Niederhauser. ... But neither the legislative leader nor Gov. Gary Herbert said they heard what they wanted to hear: that the Obama administration will let Utah cap the number of people the state covers if it expands Medicaid to everyone earning poverty-level income and less. (Moulton, 4/29)
Deseret News:
Herbert, Legislative Leaders Starting Over On Medicaid Expansion
After meeting in Washington, D.C., with U.S. Health and Human Services Secretary Sylvia Burwell Wednesday, Gov. Gary Herbert said he and legislative leaders are starting over on Medicaid expansion. "We're not back at square one. But whether it's Healthy Utah or Utah Cares or some hybrid of both, or some new invention that we will come up with, I don't know. I don't want to predict the future here," Herbert told reporters in a conference call. But the governor said he still expects to come up with a plan in time to hold a special session of the Utah Legislature this summer on using the federal funds available through President Barack Obama's health care law to cover low-income Utahns. (Roche, 4/29)
New Orleans Times-Picayune:
Medicaid Expansion Efforts Squashed By Louisiana Senate, House Panels
A Senate health panel killed legislation Wednesday (April 29) that would effectively expand Medicaid coverage for approximately 290,000 needy people in Louisiana without health insurance. After about an hour-and-a-half of testimony that ended with the sponsor of the legislation, Sen. Ben Nevers, D-Bogalusa, in tears, the committee voted 5-3 against advancing the bill to the full Senate. Nevers' bill, Senate Bill 40, wouldn't necessarily mandate the state accept Medicaid expansion but instead required the state to provide health insurance to the same group of people expansion would cover -- those whose household income is at or below 138 percent of the federal poverty level. (Lane, 4/29)
The Advocate:
Louisiana Medicaid Expansion Effort Dies Again In House, Senate Panels
Legislative panels Wednesday killed yet another effort to allow Medicaid expansion in Louisiana. It marks the third straight year Medicaid expansion efforts by Democratic legislators have died at the hands of their Republican colleagues. The Senate’s Health and Welfare Committee voted 5-3 against the legislation, which would have provided health insurance to upward of 240,000 Louisiana residents. (Shuler, 4/30)
Insurers Violate Health Law's Protections For Women, Studies Find
The National Women’s Law Center said Wednesday it had found violations in many health-plan documents regarding coverage of birth control and other issues in more than a dozen states. Responding to the findings, several Congressional Democrats called for better enforcement of the health law.
The New York Times:
Insurers Flout Rule Covering Birth Control, Studies Find
Health insurance companies often flout a federal requirement that they cover all approved methods of birth control for women without co-payments or other charges, a major benefit of the Affordable Care Act, two new studies have found. Responding to the reports, senior Democratic members of Congress prodded the White House on Wednesday to step up enforcement of the requirement. Senator Patty Murray of Washington, the senior Democrat on the Senate health committee, said she was “extremely disappointed” by the findings, and she asked Sylvia Mathews Burwell, the secretary of health and human services, to investigate the problems reported by many women. (Pear, 4/30)
The Wall Street Journal:
Women’s Group Says Insurers Aren’t Meeting Health-Law Requirements
The National Women’s Law Center, a feminist group that strongly backs the health law, said Wednesday it had found violations in health-plan documents in more than a dozen states where it investigated policies sold on the law’s insurance exchanges. The center, based in Washington, D.C., also said it had received complaints on a hotline from women from every state about problems accessing the benefits, including calls from women who got health coverage through their jobs. (Radnofsky, 4/29)
The Associated Press:
Insurers Skirt Law's Protections For Women
Some insurance plans offered on the health overhaul law's new marketplaces violate the law's requirements for women's health, according to a new report from a women's legal advocacy group. The National Women's Law Center analyzed plans in 15 states over two years and found some excluded dependents from maternity coverage, prohibited coverage of breast pumps or failed to cover all federally approved birth control methods. (Johnson, 4/29)
Kaiser Health News:
More Evidence That Health Plans Stint On Mandated Birth Control Coverage
Women’s health advocates were thrilled when the Affordable Care Act became law in 2010, because it required insurance companies to cover a broad array of women’s health services at no additional out-of-pocket cost beyond premiums. Five years later, however, that requirement is not being enforced, according to two new studies. Health insurance plans around the country are failing to provide many of those legally-mandated services including birth control and cancer screenings.(Rovner, 4/30)
Auditor: States Might Be Propping Up Exchanges Illegally
A federal auditor warns that some states may be using federal grants illegally to finance their health insurance exchanges, which are supposed to be self-supporting. And an Urban Institute study finds small businesses are most vulnerable to steep insurance increases if the Supreme Court rejects federal-exchange subsidies, while a San Antonio experiment in payment reform produces results.
The Hill:
States Might Be Using ObamaCare Grant Money Illegally
Some states running their own ObamaCare exchanges may be illegally using federal dollars to keep them afloat, according to a new warning from a government auditor. The inspector general for Department of Health and Human Services (HHS) said officials must better inform states about the purpose of the grants to prevent them from improperly using the money to prop up their health insurance exchanges. (Ferris, 4/29)
The Hill:
Report: O-Care Ruling Would Disproportionately Affect Small Businesses
Small businesses are among the most vulnerable to steep cost increases in healthcare coverage if the Supreme Court rules against ObamaCare, according to new data from the Urban Institute. In addition to the 7.5 million people who could lose their insurance subsidies if the Obama administration loses the case, nearly 3.5 million people on small-business plans would also face “substantially” higher premiums, Linda Blumberg, senior fellow for the Urban Institute, will tell a Senate panel on Wednesday. (Ferris, 4/29)
Kaiser Health News:
An Obamacare Payment Reform Success Story – One Health System, Two Procedures
To understand how the health law is supposed to fix the mediocre, overpriced, absurd medical system, you could read wonky research papers on bundled payments and accountable care organizations. Or you could look at what’s going on at Baptist Health System in San Antonio. ... Baptist made money doing what used to be industry heresy: reducing patients’ use of the medical system. The hospital group made a deal with Medicare, the huge government program for seniors, as part of an ambitious array of experiments authorized by the Affordable Care Act. (Hancock, 4/30)
CQ Healthbeat:
'Family Glitch' Puts 1.9 Million CHIP Kids At Risk
When Congress reauthorized federal funding for the state-managed Children’s Health Insurance Program for two years in April, it did not address a so-called family glitch that could jeopardize coverage for nearly 2 million children, according to state CHIP directors and children’s health advocates. As funding for the program expires in 2017, families of children now getting health insurance through CHIP will have to find policies on the state and federal exchanges established by the 2010 health care overhaul. (Evans, 4/29)
Hint Of Higher Hospital Spending Sends Health Insurer Stocks Plummeting
Despite the higher cost indications from Humana officials, most of the nation's biggest insurers have hiked earnings expectations for 2015 based on strong first-quarter results.
Modern Healthcare:
Insurer Stocks Tumble After Humana Hints At Higher Hospital Claims
Humana gave the first indication Wednesday that hospital spending could eventually eat into the earnings of health insurers. The announcement dented the stocks of all health insurers. Competitors Aetna, Anthem and UnitedHealth Group reported this month that their medical-loss ratios in the first quarter had decreased, and none said there was an underlying surge in healthcare utilization. That so far has been in direct contrast to economic indicators and guidance from hospital chain HCA that show hospital spending and admissions were on the rise. (Herman, 4/29)
The Wall Street Journal:
Humana Earnings Miss Expectations
Humana Inc. on Wednesday reported earnings that fell below analysts’ expectations on an operating basis, despite membership growth. The company reaffirmed its full-year earnings outlook (Wilde Mathews and Dulaney, 4/29)
The Associated Press:
Insurers Navigate Health Overhaul To Rising Profits
Several of the nation's biggest health insurers have hiked earnings expectations for 2015 after blowing past first-quarter forecasts and heading into a much more stable future than they faced this time last year. A better understanding of the health care overhaul's impact, lighter Medicare Advantage funding cuts and old-fashioned business growth all helped deliver a confidence boost to much of the sector. (Murphy, 4/29)
The Wall Street Journal:
Anthem Earnings Rise On Higher Enrollment, Lower Medical Costs
The Indianapolis-based Anthem echoed its competitors Wednesday in flagging restrained medical spending growth. Wayne S. DeVeydt, chief financial officer, said that if the second quarter continues the trend of the first quarter, “we clearly would have a bias toward the lower end” of its projected trend. (Wilde Mathews and Chen, 4/29)
Meanwhile, a report shows that Catholic health care giant Ascension saw higher returns from hospitals in Medicaid expansion states and coverage continues of a discrimination lawsuit against Cigna -
The St. Louis Post-Dispatch:
Ascension Health Gets Boost From Medicaid Expansion
A report released Thursday shows Edmundson-based Ascension Health has reaped the benefits of an expanded Medicaid program under the federal health care law. The study, authored by the Kaiser Family Foundation, compared Medicaid patient discharges and finances at Ascension hospitals across the country. It found that hospitals in Medicaid expansion states had higher rates of growth in patient volume and took in more revenue from Medicaid than facilities in states without expansion. (Shapiro, 4/30)
Reuters:
Cigna Sued Over Mail-Order HIV Drug Program
Cigna Corp has been hit with a lawsuit claiming that the health insurer discriminates against people with HIV/AIDS by forcing them to get some of their medications exclusively from its own mail-order pharmacy as part of a scheme to boost profits. The suit, filed on Monday in federal court in the Southern District of Florida, was brought by the advocacy group Consumer Watchdog. It alleges that Cigna's policy violates the Affordable Care Act, President Barack Obama's signature healthcare law, by discriminating against people based on their medical condition. (4/30)
Hospitals Prove Their Importance In Rural Towns
In other news, California hospitals get low grades on patient safety, and South Carolina lawmakers move a bill to make it easier to open new hospitals. Other hospital news comes from Illinois and Georgia.
The New York Times:
Hospitals Provide A Pulse In Struggling Rural Towns
This real estate to be auctioned,” reads a banner stretched across the abandoned warehouse of a store-shelving manufacturer that once employed generations living in and around this town of about 12,000. This isolated rural community has lost a lot of the energy of its heyday, when shoppers roamed downtown sidewalks, freight trains rumbled past the Big Blue River, and streets clogged at quitting time as factory workers spilled out of their plants. But it has yet to lose its economic pulse, thanks in large measure to the Beatrice Community Hospital and Health Center, housed in a sprawling new building of concrete and green glimmering windows on the outskirts of town. The hospital has become an economic anchor for the area. (Searcey, 4/29)
Los Angeles Times:
Almost 40% Of California Hospitals Graded C Or Lower For Patient Safety
Nearly four in 10 California hospitals received a grade of C or lower for patient safety in a new national report card aimed at prodding medical centers to do more to prevent injuries and deaths. The Leapfrog Group, an employer-backed nonprofit group focused on healthcare quality, issued its latest scores Wednesday, it said, so consumers and employers can be aware of poorly performing hospitals before using them.(Terhune and Smith, 4/29)
The Associated Press:
South Carolina House OKs Bill Making It Easier To Build Hospitals
The South Carolina House gave key approval Wednesday to a bill that would make it easier to build and expand hospitals and other medical facilities, and would end a state oversight program called the certificate of need entirely at the start of 2018. The bill, passed 103-1 on Wednesday, would allow existing hospitals, medical centers and nursing homes to add beds within a mile of their facility. It also would allow hospitals to expand services that are already approved under the program and remove the need to seek permission to buy costly equipment including X-ray machines or MRI scanners. (Collins, 4/29)
The Chicago Sun-Times:
Presence Health Hospitals Protest Medicaid Cuts In Illinois Budget
Hospital staff and patients at Saint Joseph Hospital — along with 10 other Presence Health hospitals across Illinois — are taking a very literal approach to protesting Gov. Bruce Rauner’s proposed cuts to Medicaid. They’re signing giant poster-size letters to state politicians and planning to hand-deliver the posters to the Capitol building in Springfield. (Sfondeles, 4/29)
Los Angeles Times:
State, L.A. County Set To Overhaul Nursing Home Oversight Procedure
Los Angeles County and state officials are preparing to realign nursing home inspection and oversight duties as part of a drive to better manage a chronic backlog of investigations into complaints of abuse and neglect. But some patient advocates say the proposed changes aren’t likely to significantly improve conditions, and could make matters worse. (Sewell, 4/29)
The Atlanta Journal-Constitution:
Gov. Deal Says It’s Too Early To Worry About Fed’s Refund Request
Gov. Nathan Deal said Wednesday it could be several years before the state knows whether it has to refund $250 million it paid to nursing homes in recent years. The federal government wants the state to return the money paid to a Middle Georgia nursing home chain, saying the payments were disallowed by Medicaid regulations. (Salzer, 4/29)
R.I. Wrestles With Ways To Reduce State's Medicaid Costs
Governor Gina Raimondo has advanced proposals to reduce Rhode Island's Medicaid spending by $90 million to balance the state budget and free up resources to invest in her economic development efforts. Meanwhile, in other news, Massachusetts is also facing health care spending challenges and companies participating in KanCare lose money.
Providence Journal:
Report On Medicaid Cuts Due Today
Thursday will bring major developments in Governor Raimondo's initiative to reduce Medicaid spending by $90 million to balance the state budget and free up money for her economic development plans. At the State House, the House Finance Committee will take up proposals the governor has already made to reduce Medicaid payments to hospitals and nursing homes. But before that, Raimondo's Reinventing Medicaid working group will unveil a report that, at the governor's request, will include recommendations on how to redesign and reduce the cost of Medicaid. (Salit, 4/29)
Rhode Island Public Radio:
No Easy Task: "Reinventing" Medicaid To Improve Health, Contain Costs
To close a burgeoning state budget gap, Gov. Gina Raimondo has proposed cutting hospital and nursing home payments. Her “Reinvent Medicaid” task force delivers its recommendations today for finding the rest of the savings in the state’s health insurance program for the poor. Their proposals are aimed at reducing the cost of caring for some of the most complex patients. ... Take a deeper look at the impact of "reinventing" Medicaid, and why it hasn't been easy to contain costs in a program on which one in four Rhode Islanders depends. Patients like Juana Kollie. (Gourlay, 4/30)
Boston Globe:
House Passes $38 Billion Budget
Facing a massive shortfall, the Massachusetts House of Representatives unanimously passed a $38.1 billion state budget on Wednesday that aims to reduce the skyrocketing growth of health care costs, spends a bit more on early education, and does not raise taxes or fees. The budget would increase spending by about 3 percent, a smaller rise than in recent years and a nod to the projected $1.8 billion gap the state would face without any action in the fiscal year that begins July 1. Much of the spending is devoted to relatively fixed costs such as MassHealth, the state’s Medicaid program — about 40 percent of the budget is set aside for that program, which serves the poor and disabled. (Miller, 4/29)
The Topeka Capital-Journal:
KanCare Companies Lose $170M In First Two Years
The companies providing coverage to Kansas’ Medicaid system lost millions last year, financial information shows, but cut down on their losses from the year before. Records indicate Amerigroup, Sunflower Health Plan and UnitedHealthcare lost a combined $52 million in 2014 after losing about $116 million in 2013. A document with profits and losses for the three managed care organizations that operate under KanCare was provided to lawmakers and obtained by The Topeka Capital-Journal. (Shorman, 4/28)
Texas, Ala. Consider Further Abortion Restrictions
Elsewhere, the House considers a vote disapproving of a D.C. law stopping employers from firing employees for abortions or contraception use.
Nexstar Broadcasting:
Alabama Legislature Looks At Abortion
Three abortion-related bills are in the Alabama legislature, all filed in the House of Representatives. Today they were up for discussion in public hearings for the House Health Committee. The Fetal Heartbeat Act would make it illegal for a physician to perform an abortion after a heartbeat has been detected. The Health Care Rights of Conscience Act would allow health care professionals to refuse to perform an abortion if it violates their conscience. And House Bill 527 would allow the Alabama Department of Public Health to refuse a health center license to an abortion clinic, among other details. (4/29)
The Texas Tribune:
Abortion Bills Gaining Momentum In Legislature
After months of little movement in the Texas Legislature on proposals to further restrict abortion, the pace is picking up as a flurry of bills moves to the House and Senate floors. Both chambers had taken up some abortion-related bills in legislative committees, but it wasn’t until last week that lawmakers began clearing the way in earnest for a variety of measures to restrict the procedure or impose additional requirements on abortion providers. (Ura, 4/29)
The Texas Tribune:
Coerced Abortion Bill Sent Back In Texas For Rewrite
The craftsmanship of a bill authored by state Rep. Molly White, R-Belton, intended to prevent women from being coerced into having abortions was met with skepticism on Wednesday by the chairman of the House State Affairs Committee, who suggested the freshman lawmaker get some "real legal folks" to help draft a better measure. White’s House Bill 1648, which came before the committee, would make it a crime to coerce or force women to have abortions, and create a 72-hour waiting period for women who indicate they are being coerced or forced. But state affairs Chairman Byron Cook, R-Corsicana, left the measure pending after other lawmakers and some anti-abortion advocates raised concerns about the details of the bill. (Ura, 4/29)
Politico:
Conservatives Demand Vote To Reject D.C. Abortion Law
The House will vote Friday on a resolution disapproving of a D.C. Law aimed at stopping employers from firing workers because of abortions or contraceptive use. Leadership scheduled the vote after a push from House conservatives, who say the law tramples on the religious liberties of employers. (French, 4/29)
The Hill:
House To Vote On Disapproving DC's Reproductive Health Law
The House plans to vote Friday on a resolution disapproving of the District of Columbia's law preventing employment discrimination based on reproductive health decisions. Congress has the power to stop laws passed by the D.C. council, but it must have the support of both chambers and the president's signature. (Marcos, 3/29)
In Third Attempt, N.C. Senate Passes Autism Coverage Bill
A bill to cover autism treatment has been passed twice by the North Carolina House of Representatives, only to die in the Senate. This week a third bill made it through. Meanwhile, Georgia now requires that insurers provide coverage for autistic children under six as the governor signs the legislation.
North Carolina Health News:
Autism Advocates Hope Third Time’s The Charm
For advocates wanting insurers to cover some expensive autism treatments, it’s been a long slog. They’ve been pushing lawmakers in the North Carolina General Assembly for years to consider a bill that would compel those insurers to cover behavioral treatments for autism. The first bill was filed in 2009 and all it did was create a committee to study the issue. It took from then until Tuesday of this week for the state Senate to pass a bill that makes it easier for families to afford some of the best behavioral treatments for their children. (Hoban, 4/29)
Georgia Health News:
Autism Coverage Becomes Law With Signing
Just a month ago, the latest attempt to require autism coverage in Georgia insurance policies appeared dead. Autism legislation was stuck in the House Insurance Committee in the waning days of the 2015 General Assembly session. Similar bills that had been proposed in previous years had stalled and ultimately failed. But this time, a compromise between House and Senate leaders led to a reworked insurance bill that added the autism requirement language. (Miller, 4/29)
The Atlanta Journal-Constitution:
Autism Insurance Coverage For Children Is Now In Georgia Law
Georgia Republicans who have long rejected the mandates in President Barack Obama’s healthcare overhaul managed to find one insurance requirement they could get behind. Gov. Nathan Deal signed legislation Wednesday that requires insurers to provide up to $30,000 a year in coverage for children 6 and under who have been diagnosed with autism. It makes Georgia the nation’s 41st state to require insurers to cover some therapy for kids with autism. (Bluestein, 4/29)
News outlets cover health care issues in North Carolina, Michigan, California, Massachusetts, Texas, Maryland, Indiana, Kansas and Minnesota.
North Carolina Health News:
Docs React To Proposed Gun Bill
Physicians and physicians’ organizations scrambled Wednesday to react to an omnibus gun-rights bill that appeared Tuesday afternoon at the General Assembly. The bill would forbid any health care provider – from doctors to dental hygienists to hospital workers – from asking a patient about their ownership or storage of firearms. Further, the bill would create a mechanism to fine doctors who did. (Hoban, 4/29)
Detroit News:
Duggan Touts Medical Cap Key To Cut Car Insurance Rates
Mayor Mike Duggan on Wednesday unveiled a plan to allow auto insurance companies to sell Detroiters lower-cost policies with a maximum of $275,000 in medical coverage for auto-related injuries. Duggan's long-anticipated proposed legislation, which he said would knock $1,000 off motorists' annual bills next year if passed, would provide $25,000 in base benefits for personal-injury protection and another $250,000 for catastrophic care for disabling injuries from in auto accidents. (Ferretti and Livengood, 4/29)
The Detroit Free Press:
Detroit Mayor Lays Out Cheap Insurance Plan For Detroiters
Mayor Mike Duggan will ask lawmakers to approve cheaper insurance plans for Detroiters that would offer lower benefit levels as a way to cut down on highest-in-the-nation premiums residents pay just for living in the city. Duggan's plan would provide a minimum $25,000 in personal injury protection and cap catastrophic medical coverage at an additional $250,000, Duggan said Wednesday night at a town hall meeting at Historic Litlte Rock Missionary Baptist Church. Health care costs beyond that level would be the responsibility of a driver's health insurance provider, the person said. (Helms, 4/30)
Los Angeles Times:
California's Individual Health Insurance Market Grows 64% To 2.2 Million
The number of Californians buying individual health insurance soared 64% to nearly 2.2 million as Obamacare took full effect last year, a new report shows. In California, 843,607 people joined the individual market both inside and outside the Covered California insurance exchange, as of Dec. 31, 2014. (Terhune, 429)
Los Angeles Times:
Theft Of Private Data On 900 L.A. County-USC Patients Investigated
Officials are investigating a security and privacy breach affecting 900 patients who were treated at the Los Angeles County-USC Medical Center’s mental health facility. The breach was discovered April 3 during a search of the home of a nurse who was employed at the Augustus F. Hawkins Mental Health Center, said Michael Wilson, a spokesman for the Los Angeles County Department of Health Services. The investigation was not related to county business, he said. (Rocha, 4/29)
KERA:
Texas Makes IUDs More Affordable, But They Aren't Popular Among Teens
Texas health officials recently made a change to doctor reimbursements that hasn’t gotten much notice. They’ve made it a little easier for low-income women and girls to get IUDs. Many health professionals see these contraceptives as the best way to stop unintended pregnancies. (Douglas, 4/29)
The Associated Press:
Texas House OKs Reporting Mandate On Pregnant Prisioners
Texas sheriffs could soon have to produce detailed reports on how they treat pregnant inmates under a bipartisan bill that has won preliminary House approval. Austin Democratic Rep. Celia Israel faced some hazing — a tradition when first-year lawmakers propose their first bill. But ultimately, her colleagues voted Wednesday to advance her plan, which now needs only a final, procedural vote to clear the House. (4/29)
The New York Times:
Health Problems Take Root In A West Baltimore Neighborhood That Is Sick Of Neglect
In Upton-Druid Heights in West Baltimore — one of the city’s poorest neighborhoods and, in recent days, the scene of some of its most vocal protests — the cost of long-term poverty is counted in lives. Its residents die from nearly every major disease at substantially higher rates than the city as a whole — nearly double the rate from heart disease, more than double the rate from prostate cancer, and triple the rate from AIDS. Life expectancy here is just 68 years, one notch above Pakistan. (Tavernise, 4/29)
The Baltimore Sun:
Mental Health Help For Residents Affected By Turmoil
The constant images and reports of a city in strife have been unsettling. And as Baltimore continues to experience the aftermath of both the death of Freddie Gray and the demonstrations and riots that followed, the need for healing is abundantly clear to mental health experts. Seeking the help of a trained mental health care provider is of the utmost importance, according to Shreya Hessler, a licensed psychologist based in Bel Air. (Williams, 4/29)
The Associated Press:
Indiana Lawmakers OK Needle Exchange Programs
Lawmakers looking to prevent a repeat of an HIV outbreak that has rocked a southern Indiana county sent Republican Gov. Mike Pence a measure Wednesday that would allow communities to implement needle-exchange programs if they can prove they're in the midst of an epidemic tied to intravenous drug use. Pence, who opposes needle exchanges as part of anti-drug policy, said in a statement Wednesday that he looks forward to signing the legislation into law. (Schroeder, 4/30)
Minnesota Public Radio:
Steps Urged To Save More Black And American Indian Babies From Early Death
Although Minnesota has one of the lowest infant mortality rates in the country — better than 42 other states — the state's good ranking masks a stark difference in mortality among racial groups. American Indian and African-American babies die at twice the rate of white babies. If those infants shared the same low mortality rate as white infants, about 40 more babies in Minnesota would survive each year. (Benson, 4/30)
Star Tribune:
Minnesota Infant Deaths Show Racial Gap
Unusually high rates of infant deaths among certain minority groups in Minnesota have state health officials searching for ways to better support mothers before, during and after their pregnancies. A Minnesota Department of Health report released Thursday revealed that babies born to black mothers are more than twice as likely to die in infancy as babies born to white mothers — giving Minnesota one of the widest infant mortality gaps in the nation. (Olson, 4/29)
WBUR:
Boston City Council Approves Paid Parental Leave Measure For Some City Workers
The Boston City Council unanimously approved a measure Wednesday to give the city’s non-union employees six weeks of paid parental leave. ... The policy would give new parents, including those who adopt, two weeks of fully paid leave, with 75 percent pay for weeks three and four, and 50 percent pay for weeks five and six. It would be available to both men and women who have worked for the city for at least a year. (4/29)
Los Angeles Times:
Sugary Drink Labeling Bill Falls Short In State Senate Panel
A measure to require health warning labels on sodas and other sugary beverages fell flat in a state Senate committee Wednesday afternoon. Sen. Bill Monning (D-Carmel) presented the bill as a tool to combat rising obesity and diabetes rates. The measure would have required sugar-sweetened drinks, including sodas, sports drinks and energy drinks, to be adorned with a label that would read "drinking beverages with added sugars contributes to obesity, diabetes and tooth decay." (Mason, 429)
Star Tribune:
Minnesota Approves Labs To Test State's Medical Marijuana
Two laboratories just got the job of quality testing Minnesota’s medical marijuana. The state is just two months away from the first legal sales of the drug. On Wednesday, the Minnesota Department of Health named its two testing facilities: Aspen Research Corp. of Maple Grove, and Legend Technical Services Inc., of St. Paul. The labs will test cannabis products to ensure they’re free of pesticides and contaminants and to confirm that they contain the drug compounds and potency promised on the label. (Brooks, 4/29)
Dallas Morning News:
Dallas-Based Teladoc Sues Texas Medical Board Over Prescription Ruling
Dallas-based Teladoc, a leading national telemedicine provider, sued the Texas Medical Board on Wednesday to stop a ruling that would require doctors to meet in person with any new patient before writing prescriptions. The suit, filed in U.S. District Court in Austin, alleges the board is trying to protect Texas physicians from competition, and warns that the April 10 ruling could “bring Teladoc to the brink of bankruptcy.” ... Teladoc works with employer-sponsored insurance plans covering nearly 11 million people to provide day-or-night access by phone or video to a physician. The company says it covers about 2.4 million people in Texas. (Landers, 4/29)
Viewpoints: Obama's 'Squandered' Legacy; Challenges Of Telemedicine; New Genetic Tests
A selection of opinions on health care from around the country.
The Wall Street Journal:
The Messes Obama Will Leave Behind
Also left for his successor are entitlement programs that will go bust: the Social Security disability trust fund in 2016, the Medicare hospital trust fund in 2030 and Social Security’s Old Age and Survivor’s trust fund in 2032. The president squandered six years by refusing to make modest reforms to hold down growth in entitlement spending while giving people time to adjust. Mr. Obama likes to claim credit for the slower growth in health spending, but economists suggest that is more likely because of the recession and the success of his predecessor’s Medicare reform, which helped seniors with prescription drug costs, resulting in fewer expensive hospital procedures and stays. (Karl Rove, d4/29)
The Wall Street Journal's Washington Wire:
Is Medicare Spending Increasing?
The Department of Health and Human Services released a report this month highlighting the slowdown in Medicare spending growth in recent years. The administration says that Obamacare has led to slower growth in overall health spending, which in turn has made Medicare more sustainable. Another government document suggests that Medicare spending may be accelerating—but even if it isn’t, demographic trends will create pressure on the program in the coming years. (Chris Jacobs, 4/29)
Dallas Morning News:
New Cancer Tests Hold Potential, But Let’s Proceed With Caution
There’s excitement around a new genetic test that can be ordered over the Internet and determine a woman’s breast and ovarian cancer risk. More women could be tested, and that’s potentially good news, but our cancer genetics team at UT Southwestern Medical Center has concerns that this could be a case of “you get what you pay for.” The new test will use a sample of saliva to analyze 19 cancer-risk genes, including the two main breast cancer-risk genes, BRCA1 and BRCA2. ... But this leads to several questions: Will those results be accurate? Some of the genetic mutations this test will identify are not fully understood. Will the women who discover a genetic mutation have the information they need to take action and prevent the disease? Will they have — and take — the opportunity to be cared for by a team of experts on hereditary cancers? (Theodora Ross, 4/29)
The New England Journal of Medicine:
Virtual Visits — Confronting The Challenges Of Telemedicine
Despite the many ways in which telemedicine may transform health care for the better, it faces a number of major challenges along the way. First, there are enduring concerns about its effectiveness and cost-effectiveness. The aforementioned benefits are theoretical, and the actual data to date are far from convincing. Most studies of telemedicine are methodologically weak before-and-after studies that rarely examine patient-centered outcomes, instead focusing on feasibility and acceptability to patients. Although these aspects are important, they are not the same as — and may not correlate with — patient-centered outcomes such as mortality and functional status. (Jeremy M. Kahn, 4/30)
The New England Journal of Medicine:
U.S.-Citizen International Medical Graduates — A Boon For The Workforce?
A recent report from the Institute of Medicine that called for reform of the financing and governance of U.S. graduate medical education has sparked controversy. Its most contentious aspect is its failure to call for more federal funding and more residency positions. Although the report acknowledges the reliance of the United States on a continuous stream of international medical graduates (IMGs) — who account for 27% of the trainees currently in U.S. residency programs — it includes no substantive discussion of IMGs. ... There are numerous reasons why we should pay attention to offshore medical schools: enrollees deserve the best education possible, and successful graduates will enter U.S. residency programs and become the teachers of U.S. medical students and caregivers for the U.S. population. To ignore the education of U.S. IMGs is to overlook a potential resource for meeting the needs of the population. (N. Lynn Eckhert and Marta van Zanten, 4/30)
Arizona Republic:
Ducey's ACA Exchange Ban Obeys The People's Will
States that set up exchanges are putting their taxpayers on the hook to the tune of tens of millions of dollars each year for carrying out onerous federal mandates. [Former Gov. Jan] Brewer and [Gov. Doug] Ducey recognized that's an expense Arizona taxpayers can't afford. But Ducey had an even stronger reason for signing HB 2643 into law: Arizona's Constitution forbids the state from setting up an exchange. In 2010, Arizona voters overwhelmingly approved the Health Care Freedom Act, which protects people's right to make their own health-care decisions. It does so by preventing the state from "compel(ling) … any person, employer or health care provider to participate in any health care system" by imposing penalties, fines, taxes or fees. (Christina Sandefur, 4/29)
Boston Globe:
Pilot Program For Postpartum Depression Deserves Approval
For most women, giving birth triggers joyful and overwhelming emotions. But for a significant number of new mothers it also causes strong and persistent feelings of anxiety, sadness, and hopelessness — clear signs of postpartum depression. Yet the maternal disorder often goes undiagnosed, or simply dismissed as “baby blues.” State Representative Ellen Story of Amherst has introduced bill after bill for the past six years to mandate postpartum depression screening in the state. On Tuesday night, the restitution of a $200,000 pilot program to screen for postpartum depression in certain communities amounted to a victory — and represents a step in the right direction in support of maternal mental health. (4/30)