Morning Briefing
Summaries of health policy coverage from major news organizations
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Trump's Effort To Lure Consumers To Exchanges Could Bring Skimpier Plans
The changes proposed by the administration for the health law marketplaces in 2018 could increase customers’ out-of-pocket costs and reduce the amount they receive in premium tax credits.
Missouri Rejects Federal Money In Order To Set Up Its Own Abortion Restrictions
Abortion is already heavily restricted in Missouri, but now the state is cutting more funding to organizations that provide abortions, even though it means rejecting millions of dollars from the federal government.
Markups On Care Can Fatten Hospital Budgets — Even If Few Patients Foot The Full Bill
A study finds that higher charges are associated with greater payments by private insurers, which can drive up costs for employers and consumers who pay their way.
Summaries Of The News:
Health Law
White House Floats Plan With Waivers For Pre-Existing Condition Rules To Woo Freedom Caucus
The Associated Press: White House Officials Offer Change To Health Care Bill
White House officials made a new offer to conservative House Republicans late Monday on the GOP's failed health care bill, hoping to resuscitate a measure that crashed spectacularly less than two weeks ago. ... Under the White House offer, states would be allowed to apply for waivers from several coverage requirements that President Barack Obama's 2010 health care law imposed on insurers. These include an Affordable Care Act provision prohibiting insurance companies from declining to write policies for people with serious diseases. Conservatives have argued that such requirements have the effect of inflating insurance costs. (4/4)
Reuters: Trump Aides, Lawmakers Hold Talks To Revive Healthcare Bill
Top White House officials met moderate and conservative Republicans in the U.S. House of Representatives on Monday in an effort to revive a plan to repeal and replace Obamacare. Key members of the administration, including Vice President Mike Pence, invited a group of moderate Republicans known as the "Tuesday Group" to the White House. Pence then went to Capitol Hill to meet the Freedom Caucus, a group of House conservatives who last month derailed a healthcare bill backed by President Donald Trump. (Morgan, 4/3)
The Washington Post: With Help From Pence, House Republicans Suddenly Rekindle Health-Care Talks
Rep. Mark Meadows (R-N.C.), the chairman of the Freedom Caucus, told reporters Monday night that the administration officials offered a “solid idea” that could form the basis of an intraparty compromise. That idea, he said, would allow states to apply for federal waivers exempting them from some health insurance mandates established under the Affordable Care Act — including “essential health benefits” requiring coverage of mental-health care, substance abuse treatment, maternity care, prescription drugs and more, as well as a provision that bars insurers from charging the sick more than the healthy. (DeBonis and Wagner, 4/3)
The Hill: Pence Presents New Healthcare Offer To Freedom Caucus
[Meadows] said that repeal of the two regulations in question would provide enough "yes" votes to pass the bill, but cautioned that the Freedom Caucus needs to review the legislative language and make sure it is adequate. (Sullivan, 4/3)
Politico: White House, Conservatives Mull Deal To Revive Obamacare Repeal
The developments could mean that Speaker Paul Ryan’s bill might not be dead after all — or at least indicate that continued discussions are going on behind the scenes. Sources stressed that the details are still being finalized, and it's far from certain that such a change would act as a silver bullet to salvage the much-maligned bill, and whether it would win over enough conservatives while also keeping centrist Republicans on board. (Bade, Haberkorn and Dawsey, 4/3)
Bloomberg: Trump White House Pushes New Health-Care Deal, Lawmakers Say
House GOP leaders said earlier that no health-care vote is planned, but several lawmakers, including a close ally of Trump’s, said they think a vote could still occur this week. “The administration would like that to happen,” Republican Representative Chris Collins, of New York, told reporters. “There’s more discussions to be had, but this was certainly a green light to continue these discussions with other members.” Collins and several Republican moderates went to the White House earlier in the day to discuss the plan. (Edgerton and John, 4/3)
CQ Roll Call: Pence Pitches Ideas To Build Support For Health Care Bill
Other attendees in the meeting included Reps. Tom MacArthur, R-N.J.; Bruce Poliquin, R-Maine; Martha McSally, R-Ariz.; Pat Tiberi, R-Ohio; Adam Kinzinger, R-Ill.; and Rodney Davis, R-Ill.; and Energy and Commerce Chairman Greg Walden, R-Ore. (Mershon, 4/3)
Roll Call: Amash, Freedom Caucus Say Health Care ‘Deal’ Reports Are False
Rep. Justin Amash and the House Freedom Caucus say talks of a deal with the White House on tweaks to legislation that would repeal the 2010 health care law are premature. Several HFC members suggested after a Monday meeting with Trump administration officials, including Vice President Mike Pence and White House Chief of Staff Reince Priebus, that they would see a legislative outline of some of the administration’s proposed changes to their health care package on Tuesday. (Garcia, 4/4)
The Hill: Paul: New ObamaCare Repeal Talk 'Helpful,' But Needs More Time
Sen. Rand Paul (R-Ky.) said Monday that talk of a compromise to win over conservatives to the ObamaCare replacement bill is "helpful" but needs more time. Multiple reports surfaced Monday that the White House and conservatives are discussing a compromise to grant Health and Human Services Secretary Tom Price more authority to allow states to waive certain ObamaCare regulations that conservatives want repealed. (Sullivan, 4/3)
Roll Call: Rand Paul Proffers Kinda, Sorta Obamacare Repeal, Replace
Before huddling with members of the House Freedom Caucus Monday, Sen. Rand Paul said he was pushing President Donald Trump on a new construct for the repeal and replacement of the 2010 health care law. Paul, a Kentucky Republican, suggested a possibility of keeping some subsidies in the 2010 law in place rather than replacing them with a new bundle of tax credits, a move that could keep conservatives from basically voting for new entitlements. (Lesniewski, 4/3)
Democrats Mobilize To Defend Health Law, Ask Trump To 'Do No Further Harm'
The Wall Street Journal: Democrats Weigh ACA Effort While Republicans Regroup After Health Bill
Democrats, hoping to seize on momentum from the apparent collapse of the Republicans’ health bill, are grappling with a tough question—whether they can do anything to prevent the Trump administration from weakening the Affordable Care Act through administrative actions by the Department of Health and Human Services. (Armour, 4/3)
The Associated Press: Repeal In Doubt, What Trump Alone Can Do On 'Obamacare'
With prospects in doubt for repealing "Obamacare," some Republicans say the Trump administration can rewrite regulations and take other actions to undo much of the health care law on its own. Some of those moves could disrupt life for millions of people, many in states that the new president carried. And then there's the risk of court challenges. Remember the White House travel ban? (Alonso-Zaldivar, 4/3)
The Cleveland Plain Dealer: How Republicans Can Tweak Obamacare Without Passing New Legislation
Even if in-fighting thwarts Republican efforts in Congress to repeal and replace the Affordable Care Act, Donald Trump's administration can act on its own to change parts of the law. (Eaton, 4/3)
Kaiser Health News: Trump’s Effort To Lure Consumers To Exchanges Could Bring Skimpier Plans
Will opening the door to cheaper, skimpier marketplace plans with higher deductibles and copays attract consumers and insurers to the exchanges next year? That’s what the Trump administration is betting on. In February, the administration proposed a rule that would take a bit of the shine off of bronze, silver, gold and platinum exchange plans by allowing them to provide less generous coverage while keeping the same metal-level designation. (Andrews, 4/4)
Meanwhile —
Roll Call: Panel Turns To Other Health Issues After Obamacare Defeat
The House Energy and Commerce Committee, following a massive setback in March in the GOP’s attempt to repeal and replace the 2010 health care law, is preparing to move ahead on several other health initiatives. The panel needs to write two major bills by Sept. 30 — one renewing the Food and Drug Administration’s authority to collect industry user fees and another reauthorizing the Children’s Health Insurance Program, or CHIP. Companies, patients and state officials affected by these measures are urging quick action. (Williams, 4/3)
Administration Confirms HHS Will Continue 'Insurer Bailout' Payments As Suit Is Litigated
The Hill: Trump Administration To Continue ObamaCare Insurer Payments During House Lawsuit
The Trump administration will continue ObamaCare's insurer payments while a House lawsuit runs its course. House Republicans sued the Obama administration over the payments — called cost-sharing reductions — that reimburse insurers for giving discounted deductibles to low-income ObamaCare enrollees. An administration official confirmed to The Hill Monday that the Health and Human Services Department would continue the payments while the lawsuit is being litigated. (Hellmann, 4/3)
Morning Consult: HHS To Continue Obamacare Payments To Insurers With Lawsuit Pending
The precedent that the cost-sharing subdues would be funded while the lawsuit is being litigated remains the policy of the current administration, according to the official, who spoke on conditions of anonymity. The statement could provide some clarity for insurers as they decide whether to offer plans next year on the Obamacare exchanges. (McIntire, 4/3)
The Fiscal Times: Under Pressure from Insurers, Trump Continues Obamacare Taxpayer Subsidies
[On] Monday, the Trump administration sent a reassuring message to the health insurance industry that it would continue to support billions of dollars of Affordable Care Act cost-sharing subsidies vital to insurers and moderate to middle-income beneficiaries while a lawsuit challenging their constitutionality works its way through the courts. (Pianin, 4/3)
The Connecticut Mirror: Insurers Lobbying To Keep ACA Payments The GOP Hates
The nation’s health insurers, which are key to the survival of the Affordable Care Act, are asking the Trump administration to keep a program congressional Republicans have sued to eliminate. Kristine Grow, spokeswoman for America’s Health Insurance Plans, said the push is to keep a “cost sharing” agreement that subsidizes co-payments and deductibles for people whose incomes fall below 250 percent of the federal poverty level, about $61,000 for a family of four. (Radelat, 4/4)
Modern Healthcare: CMS Readies Insurance Market Stabilization Rule As Insurers Wait Nervously
The CMS has sent a rule designed to stabilize the individual health insurance market to the Office of Management and Budget for final review. The Trump administration hopes to finalize the rule very soon. The administration is rushing to publish the final rule to calm insurers, who are nervously trying to decide within the next two months whether to offer plans for 2018 and what to charge for premiums. (Dickson, 4/3)
Iowa's Wellmark Announces Departure From Health Law Marketplaces In 2018
The New York Times: Iowa’s Largest Insurer Says It Will Withdraw From Obamacare Exchanges
In the latest move by insurers worried about the viability of the markets created under the federal health care law, Iowa’s major carrier said Monday that it would stop selling individual policies in the state next year. In a statement, the insurer, Wellmark Blue Cross and Blue Shield, which is based in Des Moines, blamed its decision to withdraw in 2018 on what it said was the high cost of covering people under the Affordable Care Act. (Abelson, 4/3)
The Hill: Wellmark To Leave Iowa's ObamaCare Markets In 2018
Wellmark said in a statement that it has lost $90 million in the ObamaCare markets in three years and its customers have "endured double-digit premium increases." “Finding solutions to stabilize this market is in the best interest of all Iowans, including providers of health care and insurance carriers,” Wellmark Chairman and CEO John Forsyth said in a statement. “No one really benefits from rising costs. While there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018.” (Hellmann, 4/3)
Des Moines Register: Wellmark To Halt Sales Of Individual Health Insurance Policies
Wellmark Blue Cross & Blue Shield’s decision means more than 21,000 Iowans who bought health insurance policies from the company in the past three years will need to find another carrier — and it’s not clear all of those people will have another choice. (Leys, 4/3)
Minnesota Public Radio: Minnesota Health Plans Claim Massive 2016 Losses
Minnesota's major health insurance companies said Monday their combined 2016 operating losses totaled $687 million. (Zdechlik, 4/3)
Kansas House Falls Short In Effort To Override Governor's Veto Of Medicaid Expansion
The Kansas City Star: Kansas House Fails To Override Brownback Medicaid Expansion Veto
The effort to expand Medicaid in Kansas fell apart Monday as the House failed to override Gov. Sam Brownback’s veto of a bill that would have expanded the health care program to thousands of low-income people in the state. (Woodall, 4/3)
The New York Times: Kansas House Narrowly Upholds Governor’s Veto Of Medicaid Expansion
In spite of a torrent of phone calls and in-person pleas from constituents over the weekend, and last-minute lobbying by hospital leaders who said that expanding Medicaid would help save a number of rural hospitals from closing, the vote was 81 to 44, three short of the two-thirds majority needed for an override. (Goodnough and Smith, 4/3)
KCUR: House Fails To Override Brownback Veto Of Medicaid Expansion Bill
Two House members who supported the bill in February changed their votes Monday during the override attempt. ... Two Republican House members who opposed Medicaid expansion in February — Rep. Fred Patton of Topeka and Rep. Troy Waymaster of Bunker Hill — flipped their votes and voted for the override. (Wingerter, 4/3)
The Associated Press: Kansas Lawmakers Fail To Override Veto Of Medicaid Expansion
A few rural Republicans whose support could have led lawmakers to override the veto questioned whether their struggling hospitals would have seen as much benefit from an expansion as urban areas. They also worried that extra costs associated with an expansion would hinder efforts to close projected state budget shortfalls totaling more than $1 billion through June 2019. (Hanna, 4/3)
Wichita (Kan.) Eagle: Kansas House Sustains Brownback’s Veto Of Medicaid Expansion
Melika Willoughby, Brownback’s communications director, said House members “served their constituents well today.” “While Congress and the President continue to discuss the future of health care, not expanding Obamacare is the right choice for Kansas,” she said in a statement. (Salazar, 4/3)
Advocates Rally In Richmond To Press Lawmakers To Expand Medicaid
The Richmond Times-Dispatch: Advocates Push Virginia Legislators Again To Expand Medicaid
Keith Oliver thought his prayers for health insurance had finally been answered when he received a card from Virginia’s Medicaid program. But the first time Oliver tried to use it, the doctor’s office told the 30-year-old part-time residential counselor that the card covered only family planning services under the program. ... Oliver was among four people to tell their stories of seeking vainly for health insurance and avoiding medical treatment without it, as health care advocates mounted a new offensive aimed at persuading the General Assembly to expand the state’s Medicaid program to uninsured adults and low-income families. (Martz, 4/3)
New Orleans Advocate: Pelosi, Landrieu Hear From Patients Helped By Obamacare And Medicaid Expansion
On Saturday morning, [House Minority Leader Nancy] Pelosi and Mayor Mitch Landrieu had a closed-door meeting with a group of Louisiana patients. Although there were complaints about budget-breaking premiums and unaffordable prescription drugs, there also were tales of lifesaving, life-changing access to health care under the Affordable Care Act, also known as Obamacare, that Republicans want to repeal, Pelosi said. “Their stories are our purpose,” she said. Although Louisiana has long had one of the highest uninsured rates of any state, its struggle is mirrored across the nation, Landrieu said. “America will never be great if America isn’t healthy,” he said, taking a dig at President Donald Trump's vow to "make America great again." (Reckdahl, 4/2)
Politico Pro: Medicaid Gets Short Shrift As Texas Hammers Out Its Budget
Texas lawmakers faced with a $1.2 billion Medicaid shortfall for fiscal 2017 are weighing whether to ask the Trump administration for a waiver from federal program rules. The latest version of House’s budget, passed unanimously out of the appropriations committee last week and due to be taken up by the full body Thursday, instructed the agency responsible for administering Medicaid to “pursue flexibility from the federal government” to find $1 billion in savings. (Rayasam, 4/3)
Minnesota Public Radio: The Uncertain Future For Medicaid
MPR News host Kerri Miller talks with Mary Agnes Carey from Kaiser Health News and Henry J. Aaron from Brookings Institution about what populations Medicaid really serves and what the future holds for the program. (4/3)
Administration News
Price Reaps Windfall From Selling Off Stocks At Center Of Ethics Controversy
ProPublica: Tom Price’s $150,000-Plus Stock Windfall
Tom Price doesn’t appear to have suffered a financial hit when he fulfilled his pledge to sell off some assets as the new head of the Department of Health and Human Services. On one transaction alone, Price made a profit of more than $150,000 on shares he held in a tiny Australian biotech company, according to his financial disclosures. His purchases of that stock, which came while he was serving in Congress, were the subject of particular scrutiny during his confirmation hearings in January. He was one of a handful of U.S. investors allowed to buy discounted shares in Innate Immunotherapeutics, which was working on an experimental multiple sclerosis drug. (Faturechi, 4/3)
CQ Roll Call: FDA Nominee's Vast Public Record Hints At Views On Major Issues
Scott Gottlieb, the Trump administration's choice to lead the Food and Drug Administration, will likely face questions during a confirmation hearing Wednesday about his potential for conflicts of interest and the details of his well-documented views on issues the agency oversees. Gottlieb was a deputy commissioner at the FDA during the administration of George W. Bush. Since leaving the agency a decade ago, he has been a practicing physician who also made millions of dollars advising pharmaceutical companies. (Siddons, 4/3)
Lawmakers On Both Sides Dig In Heels Over Drastic Cuts To NIH Funding
The New York Times: Plan To Cut Funding For Biomedical Research Hits Opposition In Congress
A proposal by President Trump to cut federal spending for biomedical research by 18 percent — just months after Congress approved bipartisan legislation to increase such spending — has run into a buzz saw on Capitol Hill, with Republicans and Democrats calling it misguided. “I’m extremely concerned about the potential impact of the 18 percent cut,” said Representative Tom Cole, Republican of Oklahoma and chairman of the House Appropriations subcommittee responsible for the National Institutes of Health. “This committee and certainly me, personally, will be very hesitant” to go along with the proposal, he added. (Pear, 4/3)
And former Vice President Joe Biden says cuts to research would be a stunning blow to progress —
The Washington Post: Biden Attacks Trump’s Proposed Cuts To Medical Research
Former vice president Joe Biden on Monday blasted as “draconian” President Trump's proposed cuts in funding for biomedical research, predicting that they would severely set back the budget of the National Institutes of Health, shutter labs across the United States and end promising scientific careers. Biden, in a speech to the annual meeting of the American Association for Cancer Research in Washington, said the proposed spending reductions for fiscal 2018 are sending a message that the United States is willing to cede its leadership in scientific and technical affairs. (McGinley, 4/3)
Stat: Biden Decries 'Draconian Cuts' To NIH In Trump's Proposed Budget
Biden said the proposed $5.8 billion cut to the National Institutes of Health would be a stunning blow to scientific progress. “This would set the NIH budget, and biomedical research, back 15 years — and that’s not hyperbole,” Biden said. “The chance of getting a grant would almost certainly reach an historic low.” (Keshavan, 4/3)
Veterans' Health Care
VA To Detail Improvements To Suicide Hotline Following Troubling Report On Its Flaws
The Associated Press: VA Defending Work To Fix Troubled Veteran Suicide Hotline
The Department of Veterans Affairs is telling skeptical members of Congress that it has fixed problems with its suicide hotline that were highlighted in a critical recent internal watchdog report. A March 20 audit by the VA inspector general had found that nearly a third of calls to the Veterans Crisis Line as recently as November were bounced to back-up centers run by an outside contractor. The rollover calls happen when phone lines are busy, leading to possible waits of 30 minutes or more. (Yen, 4/4)
The Associated Press: Senate Agrees To Extend VA's Program Of Private-Sector Care
The Senate on Monday approved legislation that would extend a troubled program aimed at widening veterans' access to private-sector health care, the first step in an overhaul of programs at the Department of Veterans Affairs. (Yen, 4/3)
And in other news —
The Associated Press: DOJ: For Decade, Sanofi Vaccine Unit Overcharged VA On Meds
The vaccines unit of French pharmaceutical company Sanofi SA will pay a $19.9 million fine for overcharging the U.S. Department of Veterans Affairs for two products between 2002 and 2011. By law, drug manufacturers cannot charge the VA more than a maximum level called the Federal Ceiling Price for drugs. (4/3)
Women’s Health
Administration Cuts Funding To U.N. Program, Saying It Supported Coercive Abortions
The Associated Press: Trump Admin Cites Abortion As It Halts Funding To UN Agency
The Trump administration is cutting off U.S. funding to the United Nations agency for reproductive health under an abortion-related provision in law that Democratic and Republican administrations have used as a cudgel in the global culture wars. (Lederman, 4/4)
Reuters: Federal Judge Blocks Indiana Abortion Ultrasound Measure
A U.S. federal judge blocked an Indiana measure requiring women to have an ultrasound at least 18 hours before undergoing an abortion, saying that the mandate was unnecessary and a burden to low-income women. The preliminary injunction, issued by U.S. District Judge Tanya Walton Pratt on Friday, was the result of a lawsuit brought last year by the American Civil Liberties Union (ACLU) on behalf of Planned Parenthood of Indiana and Kentucky against Indiana's Department of Health and local officials. (Mclaughlin, 4/3)
The Milwaukee Journal-Sentinel: Planned Parenthood Sure To Remain A Target In Wisconsin
Planned Parenthood of Wisconsin estimates it could keep open only two of its 19 family planning clinics — those in Milwaukee and Madison — if it was barred from billing Medicaid programs. (Boulton and Stein, 4/3)
Public Health
Alternative Approaches To Pain Gaining Victories As Opioid Epidemic Rages On
Stat: Chiropractors, Naturopaths Lobby For A Bigger Role In Treating Pain
Seizing on the opioid epidemic as a chance to expand their reach, naturopaths and chiropractors are aggressively lobbying Congress and state governments to elevate the role of alternative therapies in treating chronic pain. They’ve scored several victories in recent months, and hope the Trump administration will give them a further boost. Their most powerful argument: We don’t prescribe addictive pain pills. Shunning pharmaceuticals, they treat pain with everything from acupuncture to massage to castor oil ointments. They offer herbal supplements and homeopathic pills. (Thielking, 4/4)
In other news —
The Richmond Times-Dispatch: At Godwin, Herring Talks Indiscriminate Nature Of Heroin, Opioid Addiction
It’s a problem that defies race and walk of life. It touches people old and young, including at least two graduates who died in the past year from Mills E. Godwin High School, where Attorney General Mark R. Herring delivered introductory remarks on Monday night ahead of a documentary showing and panel discussion about the heroin and opioid epidemic that has devastated communities nationally. (Truong, 4/4)
Highly Touted Immunotherapy Can Actually Unleash Full Fury Of Cancer Rather Than Thwarting It
Stat: Immunotherapy May Hasten Growth Of Tumors In Some Patients
In a troubling phenomenon that researchers have observed in a number of cases recently, the treatment appeared not only to fail to thwart the man’s cancer, but to unleash its full fury. It seemed to make the tumor grow faster. The patient’s case was one of a handful described last week in the journal Clinical Cancer Research. Of the 155 cases studied, eight patients who had been fairly stable before immunotherapy treatment declined rapidly, failing the therapy within two months. Six saw their tumors enter a hyperactive phase, where the tumors grew by between 53 percent and 258 percent. (Tedeschi, 4/3)
The Washington Post: 20 Percent Of Patients With Serious Conditions Are First Misdiagnosed, Study Says
More than 20 percent of patients who sought a second opinion at one of the nation’s premier medical institutions had been misdiagnosed by their primary care providers, according to new research published Tuesday. Twelve percent of the people who asked specialists at the Mayo Clinic in Rochester, Minn., to review their cases had received correct diagnoses, the study found. The rest got diagnoses that were partly in line with the conclusions of the Mayo doctors who evaluated their conditions. (Bernstein, 4/4)
NPR: Overweight Americans May Have Shorter Lifespans After All
New research published Monday adds fuel to an ongoing debate in the public health community over whether a few extra pounds are good, or bad, for you. Earlier research found that being somewhat overweight, but not obese, may result in a longer life. But today's study in the Annals of Internal Medicine suggests that being slightly overweight may actually decrease a person's life span, which is more in line with conventional wisdom about weight. (Neighmond and Neel, 4/3)
The Wall Street Journal: Should You Have A Scan For Skin Cancer?
Beverly McCormick gets a full-body exam for skin cancer every six months. With blond hair, freckles and light skin, she’s not taking any chances. Ms. McCormick, a 64-year-old manager in the financial-services department at the Christ Hospital in Cincinnati, says that over the years her dermatologist has removed a squamous cell carcinoma—a type of skin cancer—as well as numerous precancerous lesions. (Reddy, 4/3)
The Washington Post: Vaccinations Significantly Reduce Risk Of Death From The Flu, CDC Study Finds
Children who were vaccinated in recent years significantly lowered their chances of dying from the flu, according to a new study from the Centers for Disease Control and Prevention. Using data from four flu seasons between 2010 and 2014, researchers found that flu vaccinations reduced the risk of flu-associated death by half among children with underlying high-risk medical conditions and by nearly two-thirds among healthy children. (Schmidt, 4/4)
Los Angeles Times: One Sister Faces Early Onset Alzheimer's. The Other Plans To Be With Her For The Journey
Like all siblings, Robin and Jessica McIntyre have had their share of battles yet they’ve always been close. And that bond grows stronger as they contend with the exceptional cruelties life has visited upon their family. This latest challenge may be hardest of all. “I have probably lived more of my life than I have left,” said Robin matter-of-factly. (Kelly, 4/3)
The New York Times: The Campaign To Lead The World Health Organization
In May, the World Health Organization will select a new director general, a choice that will affect the health of hundreds of millions in the developing world — perhaps even more if a global pandemic were to emerge. For the first time, the selection will be made by a vote of the W.H.O.’s member nations for candidates who have campaigned openly for the post. (McNeil, 4/3)
The Washington Post: Wealth Didn’t Matter. Pollution From A Coal-Fired Plant, Carried Miles By Wind, Still Hurt Their Babies.
Air pollution from power plants has wanderlust. It never stays still. It rides the wind, drifting far from its source, visiting homes miles away with potentially harmful effects. New research released Monday documents the impact that pollution from a coal-fired plant in Pennsylvania had on four wealthy New Jersey counties as far as 30 miles downwind. Women in those counties had a greater risk of having babies of low or very low birthweight — less than 5½ pounds — than did women in similarly affluent areas. (Fears, 4/3)
Los Angeles Times: Health Officials Acknowledge Effects Of Utility Leak On Alabama Residents
A chemical leak at a natural gas facility that had long been owned by San Diego-based Sempra Energy has been found to have contributed to the troubled health of residents in a poor Alabama community. The Alabama Department of Public Health announced in a recent press release that the ongoing review of the 2008 leak in Eight Mile, Ala., has determined that the chemical odorant used to detect natural gas leaks is affecting residents in the predominantly African American community of 8,000. (Penn, 4/3)
State Watch
State Highlights: Minn. Gov. Won't Veto High-Premium-Relief Plan; Iowa Lawmakers' Insurance Under Fire
Pioneer Press: Mark Dayton To Let Rescue Plan For Health Insurance Market Become Law
Minnesota Gov. Mark Dayton will allow a rescue plan for the state’s individual insurance market to become law despite having “serious concerns” about how Republican lawmakers wrote the bill. The program, called “reinsurance,” will absorb up to $271 million per year in expensive medical claims over the next two years. Those costs would ordinarily have to be paid for by insurers and passed on to their customers in the form of higher premiums. Premiums in the individual market could be lower by 20 percent in 2018 than they would be without reinsurance, the state Department of Commerce estimated. (Montgomery, 4/3)
Minnesota Public Radio: Dayton: I Won’t Block Health Insurer Relief Package
The DFL governor says he wanted more promises from health insurance companies that the money wouldn’t just go to their bottom lines, but rather would be used to buy down premiums and expand coverage options. He didn’t get those guarantees but said the need to shore up the individual insurance market led to his decision. (Bakst, 4/3)
Minneapolis Star Tribune: Dayton Won't Block $542M For Insurance Companies, But Withholds Signature
Republican lawmakers called the measure a necessary second step toward strengthening an individual market that has seen insurance companies leave and premiums rise by an average 50 percent or more in recent years. Together with the $326 million premium relief bill approved earlier this year, the state is poised to spend $868 million over the next two years to help the 190,000 people who buy insurance on the individual market. (Golden, 4/3)
Des Moines Register: Iowa Lawmakers Push Back Over Their Cheap State Insurance
Iowa lawmakers who have been taking fire for paying as little as $20 a month in state health insurance premiums are pushing back in their hometowns against the bad press. Videos taken by people who attended several town hall meetings show Iowans asking lawmakers not only to fix their cheap rates through pending legislation but to collectively reimburse the roughly $435,000 that lawmakers underpaid since January 2016. The Register reported in February that more than 100 Iowa lawmakers were paying hundreds of dollars less than they should for their state-provided health insurance — a potential violation of state law. (Clayworth, 4/3)
The Philadelphia Inquirer: Can Pa. Find A Way Out For Thousands Of Mentally Ill Inmates Languishing In County Jails?
Forty percent of Philadelphia inmates are on psychotropic medications; 17 percent have what’s considered a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. At the state level, 29 percent of inmates have a mental illness. People with mental illness also stay longer in jail, and are more likely to return. So, on Tuesday, state officials will announce a multiyear initiative aimed at safely reducing the number of people with mental illness in Pennsylvania jails -- a problem that has so far been intractable in the face of criminal-justice reform efforts. (Melamed, 4/3)
NJ Spotlight: Building A Secure Database For Patients’ End-Of-Life Plans
New Jersey could soon join a handful of states that use electronic registries to help ensure healthcare providers treat patients according to their wishes when it comes to end-of-life care — instead of automatically using all available medical technology to keep them alive. State Health Commissioner Cathleen Bennett joined officials from the New Jersey Hospital Association on Friday to unveil the new electronic Practitioner Orders for Life-Sustaining Treatment (POLST) initiative that they hope will engage more patients and make their information far more accessible to those providing medical care. (Stainton, 4/3)
St. Louis Post Dispatch: St. Charles County Excels At Healthy Living, National Survey Says
For the eighth consecutive year, St. Charles County ranks at the top of Missouri’s “Healthiest Counties” list. The county finished first in Missouri in the category of "health factors" and second in the state for “health outcomes. "The report, which looks at 115 Missouri counties, was released by the University of Wisconsin and the Robert Wood Johnson Foundation. (Holleman, 4/3)
The Texas Tribune: Houston Foster Child Death Spurs Concerns Over Placement Shortages
As Texas Department of Family and Protective Services officials continue investigating the death of a girl who escaped a Child Protective Services office, advocates and legislators are grappling with the worst-case scenario of the state's shortage of homes for abused and neglected children. (Evans, 4/3)
The Tampa Bay Times: Senate Clears Medical Marijuana Bill, Expanding Grower Licenses
State senators on Monday gave their first approval to a major overhaul of their medical marijuana legislation. (Austen, 4/3)
Pioneer Press: $75 Million Neuroscience Center Opens On Phalen Boulevard, St. Paul's 'Medical Corridor'
Inside the 130,000-square-foot facility, video cameras linked to two underwater treadmills record and analyze the gait of stroke victims in a climate-controlled therapy pool. A floor below, 16 privately-funded researchers — surrounded by beakers, microscopes and hypersensitive digital scales — search for cures to dementia and Alzheimer’s disease. A floor above, images displayed on large flat-screen wall monitors will show patients the interior of their own tumors, spines and frontal lobes, a visual road map to complicated medical conditions. Clinical trials, physical rehab, patient diagnosis and lab work will all happen in the same building. (Melo, 4/3)
Editorials And Opinions
Perspectives On Medicaid Expansion Disappointments And Dreams; The GOP And Its Next Health Policy Iterations
The Kansas City Star: Medicaid Rejection A Shame On Kansas
The Kansas House fell three votes short Monday of overriding Gov. Sam Brownback and approving Medicaid insurance coverage for about 150,000 of the state’s residents. The decision is tragic. We applaud the 81 members of the House — far more than a simple majority — who endorsed a plan to give hope to lower-income Kansans who are sick or need help to stay well. The thousands of ordinary Kansans who sent emails or made phone calls to legislators urging an override also should be commended. Your work must continue. (4/3)
The Wichita Eagle: Lawmakers Side With Brownback, Not Public
It is disheartening that the Kansas House failed by three votes Monday to override Gov. Sam Brownback’s veto of Medicaid expansion. It’s also disappointing – but not surprising – that more than a dozen Wichita-area GOP lawmakers were among the 44 House members who voted to sustain Brownback’s veto. All but one of them have consistently opposed Medicaid expansion. Rep. Joe Seiwert, R-Pretty Prairie, said he supported expansion when he ran for re-election last November, yet he voted against the bill and the override attempt. (4/3)
The Des Moines Register: Kansas Should Know That Health Care Makes Working Possible
Last week Kansas Gov. Sam Brownback vetoed legislation that sought to expand Medicaid to 150,000 residents under the Affordable Care Act. This is noteworthy because the bill was passed by the state’s Republican-controlled Legislature. Better late than never, Kansas lawmakers have figured out what the majority of states know: It makes sense to use the federal law to provide health insurance to poor people and collect a windfall of Washington dollars to pay for that coverage. But Brownback doesn't get it. His veto message underscores the misguided thinking behind the resistance in Republican-controlled states that refuse to expand Medicaid. (4/3)
Richmond Times-Dispatch: McAuliffe And Northam Call On GOP To Expand Medicaid. Good Luck With That, Fellas.
In seemingly coordinated op/ed columns in other papers over the weekend, Gov. Terry McAuliffe and Lt. Gov. Ralph Northam called on Virginia Republicans to approve Medicaid expansion. McAuliffe and Northam know perfectly well Republicans won’t do that, but pushing the issue could help Northam in the governor’s race. That makes Northam’s closing statement that “it’s time to put politics aside” more than a trifle disingenuous. (4/3)
The New York Times: Republican Health Proposal Would Undermine Coverage For Pre-Existing Conditions
Throughout the debate to repeal and replace the Affordable Care Act, President Trump and Republican congressional leaders have insisted they would retain a crucial, popular part of the health law: the promise that people can buy insurance even if they’ve had illnesses in the past. Their efforts foundered last month, when a House health bill had to be pulled from the floor after it failed to attract enough support. (Margot Sanger-Katz, 4/4)
USA Today: Republicans Cannot Give Up On Health Care
Repealing the failure of Obamacare and replacing it with a plan that actually provides affordable and quality health care for families is something that I focused on long before I became governor. In 2009, when I was a private citizen, I launched Conservatives for Patients’ Rights because I was concerned about the ramifications Obamacare could have for our nation. What I fought hard against immediately came true. Under Obamacare, costs have skyrocketed and families cannot keep the doctors they like. Obamacare was sold on a lie, plain and simple. (Gov. Rick Scott, 4/3)
The Wichita Eagle: New Health Policy: Willful Neglect
And so the stage is set not for outright repeal or repeal and replace or any effort to fix the system. It’s set for sabotage. Here’s how it will happen, unless Trump and Price recover their consciences or congressional Republicans hear enough from back home to fear for their political lives in the 2018 elections. The ACA’s 1,442 “shalls” and “wills” each represent a dial that Price can tweak on his own – at least until he’s taken to court. (Davis Merritt, 4/4)
The Charlotte Observer: GOP Infighting Turns Ominous For Trump And The Party’s Agenda
The political disaster that was the non-repeal of Obamacare last month was bad enough. But now its recriminatory aftershocks, fully joined by President Trump himself, augur ill for the future of the Republican agenda this year – and maybe beyond. The president was understandably frustrated in his first major legislative campaign. He worked the phones late most nights to round up GOP votes to pass the imperfect, long-promised repeal out of the House of Representatives. (Andrew Malcolm, 4/3)
Viewpoints: Gen X And The Future Of Health Care; Facing Down The Opioid Crisis
Stat: Look To Generation X To See The Future Of Health Care
Moviemakers once portrayed Generation X, born between the mid-1960s and 1980, as angst-ridden adolescents in films like “The Breakfast Club.” Today, Generation Xers have teenagers of their own — as well as aging parents to look after. Caught up in careers, teetering on the cusps of menopause and mid-life crises, these former slackers now make millions of high-impact health decisions every day. It’s an interesting generation for many reasons. Gen Xers were the first to grow up in an era of internet-available health information. They also grew up with direct-to-consumer advertising for prescription drugs and consumer activism in health care. They witnessed firsthand the AIDS crisis and the dawn of health advocacy. As a result, they bring a less passive and more discerning attitude towards health than the generations that preceded them. (Lynn O’Connor, 4/3)
The New York Times: Let’s Go For A Win On Opioids
The health care bill failed. The odds of successful tax reform are remote, and in any case an actual proposal is months away. If we lived in a normal country our president would use the current moment to try to get a win — to try to pass something that would help people, demonstrate that Washington can function and rebuild his brand. If we lived in a normal country the Trump White House would launch a major initiative to combat opiate addiction. There are roughly two and a half million Americans addicted to opioids. Between 1999 and 2015, the number of those who died rose from 8,200 annually to 33,000. That means that over two years more Americans died of opiate addiction than died in the entire Vietnam War. (David Brooks, 4/4)
The Columbus Dispatch: Drug Crisis Front And Center
But no governor could have foreseen the stunning breadth and depth of today’s drug crisis in Ohio — the worst in the nation. The drug epidemic is not the result of a failure of political leadership. Year by year, Ohio’s political leaders have recognized the growing problem, and have attempted to respond. Only to lose ground. (4/4)
Stat: Gottlieb As FDA Commissioner Would Be Music To Pharma’s Ears
When President Trump nominated Scott Gottlieb for commissioner of the Food and Drug Administration, you could almost hear the sigh of relief that rippled through the health care community. (Judith Garber and Shannon Brownlee, 4/4)
The New York Times: Birth Control Causes Depression? Not So Fast
One of the biggest American public health victories of the last decade has been the record low reached in the teenage birthrate. Along with that have been lows in rates for teenage pregnancy and abortion. Most researchers believe that improved access to contraception is a large part of this success. But news continues to focus on the concern that hormone-based contraception — like the pill or the patch — causes depression, and that this should lead us to question its wider use. A more nuanced discussion would consider both the benefits and the harms. (Aaron E. Carroll, 4/3)
The Des Moines Register: In Iowa, Strong Support For Planned Parenthood Is A Republican Value
One of Republicans’ core beliefs is that every person can take part in the economic opportunity of our country. If women don’t have the ability to make decisions about when and whether to have children, they’re not in control of their economic future. If we take away their access to basic reproductive health care like birth control, we’re taking away their ability to chase the American dream. (Alan Zuckert, 4/3)
Stat: How A $37,000-A-Year Medicine Sets A Good Model For Drug Pricing
Shortly before his company won the right last week to sell a new drug for severe eczema, Dr. Len Schleifer made a brash promise. He vowed to price the medicine “responsibly” and avoid the anger that high drug prices have stirred. (Ed Silverman, 4/3)