- KFF Health News Original Stories 3
- Seniors' Wait For A Medicare Appeal Is Cut In Half
- Is Your Heart Doctor In? If Not, You Might Be Better Off.
- Can I Keep My Marketplace Plan When I’m Enrolled In Medicare?
- Political Cartoon: 'All That Pizzazz?'
- Health Law 2
- Supreme Court To Hear Big Health Law Challenge In March
- Medicaid Program Challenged In Pa.
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Seniors' Wait For A Medicare Appeal Is Cut In Half
Federal officials handle most of the requests in 2014 from beneficiaries seeking a hearing before a judge and cut into the heavy backlog. But cases from hospitals, doctors and other providers are still on hold. (Susan Jaffe, 12/23)
Is Your Heart Doctor In? If Not, You Might Be Better Off.
A new study finds that high-risk heart patients in teaching hospitals do better during the times that cardiologists gather for national conventions. (Jordan Rau, 12/22)
Can I Keep My Marketplace Plan When I’m Enrolled In Medicare?
KHN’s consumer columnist answers a reader’s question about whether coverage from the health law’s online exchanges is compatible with Medicare and another question on Medicare drug coverage options when seniors move. (Michelle Andrews, 12/23)
Political Cartoon: 'All That Pizzazz?'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'All That Pizzazz?'" by Darrin Bell.
Here's today's health policy haiku:
MAYBE BETTER THAN AN APPLE
It seems very strange,
But some heart patients fare well
When their doc is gone.
- 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:
Supreme Court To Hear Big Health Law Challenge In March
Meanwhile, federal officials move to make health coverage summaries more user-friendly.
The Wall Street Journal:
Supreme Court To Hear Arguments In Big Health Care Case On March 4
The Supreme Court said it will hear oral arguments on March 4 in a lawsuit over whether the Obama administration is improperly providing tax credits to consumers who purchase health insurance through the federal exchanges. The case will determine the fate of the tax credits to millions of consumers who have obtained insurance coverage through HealthCare.gov, the federal marketplace. (Armour, 12/22)
Fox News:
Supreme Court Sets March Hearing For New Obamacare Case
In July, a Richmond, Virginia-based appeals court upheld Internal Revenue Service regulations that allow health-insurance tax credits under the Affordable Care Act for consumers in all 50 states. On that same July day, a panel of appellate judges in Washington, District of Columbia, sided with the challengers in striking down the IRS regulations. (12/22)
The Hill:
Gruber Comes To Supreme Court
Jonathan Gruber has arrived at the Supreme Court. The controversial consultant's name appears six times in a 129-page opening brief for plaintiffs challenging Obamacare in the blockbuster case King v. Burwell. The case, which will be heard by the Supreme Court on March 4, could erase health care subsidies in dozens of states. (Ferris, 12/22)
The Hill:
HHS Proposes Changes To O-Care Benefit Summaries
Federal officials are proposing to make the benefit summaries required for health plans on Obamacare's marketplaces more user-friendly. The Department of Health and Human Services (HHS) announced plans to streamline the documents while adding new information that will help consumers better understand cost-sharing. (Viebeck, 12/22)
Medicaid Program Challenged In Pa.
The challenge does not target the expansion of benefits to up to 600,000 Pennsylvanians who will become newly eligible Jan. 1.
Pittsburgh Post-Gazette:
Lawsuit Challenges Changes To Healthy Pennsylvania
Community Legal Services of Philadelphia filed a lawsuit Monday asking the courts to stop changes to the health benefits of low-income Pennsylvanians from taking effect Jan. 1 under Gov. Tom Corbett’s signature health plan. The organization says changes under the Healthy Pennsylvania initiative will result in “severe cuts” to the health benefits of nearly 200,000 low-income Pennsylvanians. (Langley, 12/22)
PennLive:
In Lawsuit, Groups Claims Corbett's Medicaid Changes Cut Benefits To 200,000
The lawsuit follows news last week of a separate issue related to Gov. Tom Corbett's overhaul of the state's Medicaid program. Hundreds of health care providers across Pennsylvania are currently not receiving reimbursement from the state for care given to drug addicts and mentally ill patients on Medicaid, better known as HealthChoices. ... Kait Gillis, press secretary for the Department of Human Services, said Monday evening that the department disagrees with the lawsuit's allegations and it is preparing a legal response. (Simmons-Ritchie, 12/22)
Columbus Dispatch:
Medicaid Extension Again On Kasich Agenda
Nearly one year after Ohio expanded Medicaid coverage for poor adults, Gov. John Kasich again faces uncertainty as he seeks approval from the Republican-led legislature to extend new eligibility guidelines for two more years. ... As of October, more than 430,000 poor Ohioans had gained health coverage under the expansion paid through federal funding available through the Affordable Care Act. (Candisky, 12/23)
Other stories track enrollment reports from state exchanges in Washington and New York -
The Seattle Times:
As Deadline Looms, Consumers May Get More Time To Pick Plan
Enrollment in health plans sold on the state’s Washington Healthplanfinder insurance exchange hits a major deadline at 5 p.m. Tuesday. That’s the point by which consumers need to select and pay the first month’s premium on plans for coverage effective Jan. 1. But consumers who, through no fault of their own, have had problems completing their enrollment or renewal on the Healthplanfinder site may get more time, according to Michael Marchand, communications director of the Washington Health Benefit Exchange, which operates Healthplanfinder. (Marshall, 12/22)
The Associated Press:
NY Health Exchange Reports 225,000 More Enrolled
New York's health exchange reports more than 225,000 people have newly enrolled for coverage starting next year. The Health Department says that total includes 83,057 people covered by private insurers and 142,187 by Medicaid. In the first year of the exchange, New York enrolled 370,604 people with commercial and nonprofit insurers. Another 525,283 enrolled in Medicaid and 64,875 in the state's Child Health Plus coverage. (12/22)
Feds To Investigate If Insurers Discriminated Against Sick
The Obama administration said it had become aware of “discriminatory benefit designs” that discouraged people with costly chronic illnesses such as AIDS from enrolling because of age or medical condition, The New York Times reports. Also, a California group sues Aetna, alleging that requirements for mail-order drugs threaten patient privacy.
The New York Times:
Obama Administration To Investigate Insurers For Bias Against Costly Conditions
The Obama administration said Monday that it would investigate prescription drug coverage and other benefits offered by health insurance companies to see if they discriminated against people with AIDS, mental illness, diabetes or other costly chronic conditions. The administration said it had become aware of “discriminatory benefit designs” that discouraged people from enrolling because of age or medical condition. (Pear, 12/22)
The New York Times:
Group Sues Aetna, Claiming Discrimination Against H.I.V. Patients
A consumer group has sued the health insurer Aetna, claiming that it discriminated against patients with H.I.V. when it required them to obtain medications exclusively through its own mail-order pharmacy. The lawsuit, filed Friday in federal court in San Diego by the advocacy group Consumer Watchdog, argues that Aetna’s policy violates the new federal health care law, which prohibits insurers from discriminating against people based on medical condition. (Thomas, 12/22)
The Associated Press:
Consumer Group Sues Aetna, Alleges Discrimination
A consumer advocacy group has filed a class-action lawsuit against Aetna Inc. saying a new policy violates the privacy of people with HIV and AIDS by requiring them to get their medications from its mail-order pharmacy. Consumer Watchdog filed the lawsuit Friday in federal court in San Diego. It says sending the drugs through the mail puts privacy at risk because packages could end up at the wrong address or be seen by others. It also says the mail is not a reliable way to ensure people get their medications on time. (Watson, 12/22)
In addition, Marketplace looked at the steep rise in insurance premium prices --
Marketplace:
The Math Behind Health Care's Crazy Inflation
In 1996, the average family premium ran just shy of $5,000. Adjust that $5,000 for inflation, and today it’s about $7,500. But healthcare premiums are a different story. The cost was a little more than $16,000 for a family, as of last year. (Gorenstein, 12/22)
North Carolina Abortion Law Struck Down By U.S. Appeals Court
The 4th Circuit Court of Appeals in Richmond, Va., ruled that the 2011 law requiring doctors to perform ultrasounds and describe sonogram images to pregnant women at least four hours before an abortion is "ideological in intent" and violates doctors' free-speech rights.
Los Angeles Times:
North Carolina Abortion Law Struck Down By Federal Appeals Court
A federal appeals court Monday ruled that a North Carolina abortion law requiring doctors to perform ultrasounds and describe sonogram images to women is unconstitutional because it violates free speech rights. ... A provision in the Women's Right to Know Act requires doctors to display sonogram images of fetuses and to describe them to women at least four hours before an abortion procedure. "Transforming the physician into the mouthpiece of the state undermines the trust that is necessary for facilitating healthy doctor-patient relationships and, through them, successful treatment outcomes," the three-judge panel wrote. (Zucchino, 12/22)
The Associated Press:
Appeals Court Strikes Down NC Abortion Law
A North Carolina law requiring abortion providers to show and describe an ultrasound to the pregnant woman is "ideological in intent" and violates doctors' free-speech rights, a federal appeals court ruled Monday. Fourth U.S. Circuit Court of Appeals Judge J. Harvie Wilkinson III wrote that the law goes far beyond what most states have done to ensure that a woman gives informed consent to an abortion. (O'Dell, 12/22)
Reuters:
U.S. Court Strikes Down North Carolina Ultrasound Abortion Law
A North Carolina law that required physicians to perform an ultrasound, display the sonogram and describe the fetus to women seeking abortions is unconstitutional, a federal appeals court ruled Monday. The United States Court of Appeals for the Fourth Circuit in Richmond, Va., upheld a district judge’s decision striking down the 2011 law, which was passed by North Carolina’s Republican-led legislature over a veto by Gov. Bev Perdue, a Democrat. (12/22)
Study: Some Heart Patients Do Better When Doctors Are Away
Elsewhere, new draft guidelines suggest yearly blood pressure tests for everyone over 40 years old or if they have other risk factors.
The Associated Press:
Do Heart Patients Fare Better When Doctors Away?
Doctors joke that if you're going to have a heart attack, the safest place would be at a big national gathering of heart specialists. But a new study suggests some older hospitalized heart patients may fare better when these doctors aren't around. (Tanner, 12/22)
Los Angeles Times:
Some Heart Patients Do Better When The Cardiologist Is Away
Holy heart attack! Researchers have found that certain high-risk heart patients stand a better chance of survival if they go to a teaching hospital when all the cardiologists have left town. ... In research published Monday in JAMA Internal Medicine, study authors found that the survival rate for high-risk cardiac arrest patients rose 10% when they were admitted to a major teaching hospital on days that a national cardiology meetings was in session. (Morin, 12/22)
Kaiser Health News:
Is Your Heart Doctor In? If Not, You Might Be Better Off.
If your cardiologist is away at a conference when you’re having a stabbing feeling in your chest, don’t fret. You may be more likely to live. A study published Monday in the journal JAMA Internal Medicine found frail patients admitted to teaching hospitals with two common types of heart problems were more likely to survive on days when national cardiology conferences were going on. (Rau, 12/22)
Los Angeles Times:
Panel Recommends Blood Pressure Screening To Stop A 'Silent Killer'
Health authorities in the U.S. are taking fresh aim at a “silent killer” with a recommendation that all American adults be screened for high blood pressure. People should be screened once a year if they are at least 40 years old, if they are overweight or obese, if they are African American, or if their blood pressure is in the “high normal” range, according to a draft recommendation released Monday by the U.S. Preventive Services Task Force. Adults ages 18 to 39 who have no risk factors for high blood pressure should be screened once every three to five years, the panel said. (Kaplan, 12/22)
Patients, Doctors Applaud Hep C Drug Deal But With Caveats
While the agreement between Express Scripts, the nation's largest pharmacy benefits manager, and drug maker AbbVie will make the new hepatitis C treatment Viekira available to people with early stage liver disease, some patients will not be good candidates for it. Meanwhile, Express Scripts will cover the $84,000 Sovaldi only in limited cases.
The Wall Street Journal's Pharmalot:
Special Sale Price: Docs Divided Over Discount On AbbVie Hepatitis C Drug
The decision by Express Scripts to make the AbbVie hepatitis C treatment the exclusive option for patients with the most common type of the virus caused a ruckus on Wall Street, although the reaction among some doctors and patient advocates was mixed. (Loftus, 12/22)
Marketplace:
A New Drug Becomes The Only Option For Some Patients
A newly-approved drug for Hepatitis C will be the only treatment covered for many patients whose employers use a company called Express Scripts for their pharmacy benefits. Last year, Gilead Sciences Inc. introduced a highly-effective hepatitis C drug, with an $84,000 price tag. Those kinds of prices have been more common for drugs treating conditions so rare they are sometimes called “orphan diseases." Hepatitis C, on the other hand, affects more than three million people. (Weismann, 12/22)
The Associated Press:
Express Scripts Turns To AbbVie In Huge Hep C Deal
The nation's largest pharmacy benefits manager is throwing its weight into the fight over high-cost hepatitis C drugs with a coverage restriction that might ultimately lower prices and improve patient access to groundbreaking treatments for the liver-destroying virus. Express Scripts said Monday that it will no longer cover Sovaldi and Harvoni — two Gilead Sciences drugs that cost more than $80,000 each for a full course of treatment — or Johnson & Johnson's Olysio starting Jan. 1, except under limited circumstances. Instead, it will make AbbVie Inc.'s Viekira Pak, approved only Friday, the preferred treatment for patients who have the most common form of hepatitis C, genotype 1. (Murphy, 12/22)
The St. Louis Post-Dispatch:
Express Scripts To Drop Hep C Drug Sovaldi, Offer Competing Viekira Pak
Express Scripts, the nation’s largest pharmacy benefit manager, will stop covering the expensive hepatitis C drug Sovaldi on Jan. 1. Instead, the St. Louis County-based company has opted for a rival drug, Viekira Pak, which the Food and Drug Administration approved on Friday. Express Scripts Holding Co. said the move would not only save employers money but would allow more people to receive life-saving medical treatment. (Liss, 12/21)
More People With Chronic Conditions Turn To Palliative Care
The therapies, often used for patients with terminal illnesses, are now being tried to treat people dealing with diseases such as multiple sclerosis and Parkinson's. Also, The New York Times examines restaurant offerings with big calories.
The Wall Street Journal:
Patients Turn To Palliative Care For Relief From Serious Illness
Patients with serious illnesses need medical treatments to survive. But they are increasingly taking advantage of the specialty known as palliative care, which offers day-to-day relief from symptoms as well as stress and lifestyle management. Though often regarded as only for older patients with terminal illness before they enter hospice programs at the end of life, palliative care is increasingly being offered to patients of any age with a range of chronic illnesses such as cancer, multiple sclerosis and Parkinson’s. (Landro, 12/22)
The New York Times' Upshot:
What 2,000 Calories Looks Like
The nation’s largest restaurant chains have made a big deal in recent years about introducing smaller portion sizes. McDonald’s eliminated the Supersize menu, while T.G.I. Friday’s and others have introduced small-plate items. Yet the restaurants have also been doing something else, with less fanfare: continuing to add dishes so rich that a single meal often contains a full day’s worth of calories. Here, we show you what roughly 2,000 calories looks like at some large chains. (Barro, Griggs, Leonhardt, Cain Miller and Cenicola, 12/22)
CDC Director Sees Progress In Ebola Fight
After a week-long visit to West Africa, Thomas Frieden, who heads the federal Centers for Disease Control and Prevention, says he sees "real momentum" in Liberia, but also “sobering” challenges, such as a shortage of beds, in neighboring Sierra Leone and Guinea.
The Washington Post:
CDC Director Frieden Cites Progress, Challenges In Ebola Fight After W. Africa Trip
Despite progress fighting Ebola in Liberia, a surge in the number of cases and a shortage of treatment beds in neighboring Sierra Leone and Guinea pose “sobering” challenges to stopping the epidemic in West Africa, the head of the Centers for Disease Control and Prevention said Monday. CDC Director Thomas Frieden said the conditions he saw on a week-long trip to the three hardest-hit countries were “a world of difference” from his visit in late August and September, when the number of cases was increasing exponentially in Liberia and dead bodies lay in streets and in treatment centers. (Sun, 12/22)
Los Angeles Times:
CDC Chief: 'World Of Difference' In Ebola Fight, But Complacency A Risk
The fight against the Ebola virus in West Africa has seen some “real momentum and progress” in the last few months but remains imperiled by complacency as hot spots of the disease continue to sprout across the region, the head of the U.S. Centers for Disease Control and Prevention said Monday. ... To shut down the Ebola outbreak, Frieden told reporters, healthcare workers must continue adhering to strict protocols and use of personal protective equipment, and officials must be able to effectively trace every patient’s contacts closely to shut down chains of transmission. “Until they get to zero, we in the U.S. will not be safe from other potential imported cases,” Frieden said. (Mai-Duc, 12/22)
Lawmakers, Reports Say VA Projects Wasting Billions
And, in Kansas, researchers says the federal government lacks a proper plan to care for returning soldiers wounded on the battleground.
CNN:
Controversial VA Projects Waste Billions, Say Government Reports And Lawmakers
While veterans in recent years were dying as they waited for care at Department of Veterans Affairs hospitals, the VA has wasted billions of taxpayer dollars on controversial projects across the country, according to government reports and members of Congress. ... For example, a massive construction project near Denver mired with problems ran hundreds of millions of dollars over budget and ended up in court over design and contract issues, according to court documents. (Devine, 12/23)
The Kansas Health Institute News Service:
Wounded Veterans Return To Unprepared Medical System
A sniper’s bullet tore through U.S. Army Sgt. Jamie Jarboe’s neck while he was on patrol during a tour of duty in Afghanistan in April 2011. ... Jarboe arrived back on American soil paralyzed but alive and was able to get the best care the military had to offer at Walter Reed Army Medical Center in Washington, D.C. But less than a year later he was dead from complications of surgery, one of several medical errors that his wife, Melissa Jarboe, documented (Marso, 12/22)
State Highlights: Communities' Mental Health Failures; Medicaid And EHRs
A selection of stories that affect states and local communities around the country.
USA Today:
Solutions To Woes Of Mentally Ill Exist But Aren't Used
The USA could dramatically improve the lives of the 10 million Americans with serious mental illness if it would make wider use of proven programs. "We know what to do," says Ron Honberg, national director of policy and legal affairs at the National Alliance on Mental Illness. "We just don't do it." Most communities ignore mental health until there's a crisis, such as the school shootings in Newtown, Conn., two years ago. ... Studies show that supported housing, which provides a variety of services beyond low-cost apartments, not only reduces homelessness but also helps participants spend less time in shelters, hospitals and jail. (Szabo, 12/22)
Politico Pro:
States Fail To Track Medicaid EHR Payments
The vast majority of states and the federal government have little data on how many doctors seeing the nation’s poorest patients are using electronic health records, although nearly $9 billion has been disbursed by the program that gives incentives for the technology’s adoption. (Pittman, 12/22)
ProPublica:
In Alabama, A Public Hospital Serves The Poor -- With Lawsuits
More than a century ago, Alabama enshrined a basic protection in the state’s constitution shielding its poorest citizens from being forced to pay debts they couldn’t afford. But a public hospital in the mostly rural southeast corner of the state has found a way around the law. ... ProPublica and NPR reported last week that nonprofit hospitals, which are legally required to offer discounted care to the poor, often sue low-income patients and garnish hefty portions of their pay. But ProPublica found similar tactics are wielded by public facilities that often serve as hospitals of last resort. (Kiel, 12/22)
The Associated Press:
Ruling Opens Door For Cruise Malpractice Lawsuits
Pasquale Vaglio, a retired New York City policeman and Korean War veteran, was on the cruise of a lifetime with 18 family members in the summer of 2001 ... Then, the accident happened. Vaglio, 82, fell and hit his head ... a nurse did a cursory examination and said Vaglio should rest in his cabin. What she didn't know — and a doctor wouldn't discover until hours later — was that Vaglio had suffered a brain injury that would kill him within days. For more than 100 years, people such as Vaglio's survivors couldn't win medical malpractice lawsuits against cruise lines. (Anderson, 12/23)
Viewpoints: Vermont's Insurance 'Washout;' Struggles For A Small Business Owner
A selection of opinions on health care from around the country.
The Wall Street Journal:
Vermont’s Single Payer Washout
Believe it or not, there really are liberals disappointed that ObamaCare does not involve more taxation and central planning of medicine. So be grateful for the state laboratories of federalism and in particular Vermont, where the purest progressive version of ObamaCare has imploded. Last week, in a reversal that deserves more attention, Democratic Governor Peter Shumlin announced that Vermont would no longer create America’s first statewide single-payer health system. (12/22)
The New York Times:
Is This Any Way To Pick A Company Health Insurance Plan?
One thing I do know is that I’m going to stop and think long and hard about whether to go through this effort again next year. ... And that’s when the insurance companies and health care providers will have won. They’ve managed to erect a system that is so complex that only an extreme effort on the part of business owners leads to any understanding of what the choices are and what is the best path forward. When the majority of owners no longer feel like making that effort, then there’s no constraint on future cost increases. The only rational choice will be for small companies to simply stop offering coverage, and pass all of the responsibility to their workers. (Paul Downs, 12/22)
The New York Times:
Sugar Season. It’s Everywhere, And Addictive.
Your co-worker brought in brownies, your daughter made cookies for a holiday party and candy is arriving from far-flung relatives. Sugar is everywhere. It is celebration, it is festivity, it is love. It’s also dangerous. ... Yet people can’t resist. And the reason for that is pretty simple. Sugar is addictive. And we don’t mean addictive in that way that people talk about delicious foods. We mean addictive, literally, in the same way as drugs. And the food industry is doing everything it can to keep us hooked. (James J. DiNicolantonio and Dr. Sean C. Lucan, 12/22)
JAMA:
The 2014 Ebola Outbreak And Mental Health
Ebola can affect many segments of a functional society. What started as a public health emergency has been officially declared a global threat ...The West Africa pandemic provides insights into the psychological consequences associated with a “worst case scenario” event involving a highly virulent infectious disease. An effective response is essential both in West Africa to address the psychosocial needs associated with population-wide direct exposure to disease, death, and distress; and in the United States, to counterbalance fear-driven behaviors and policy making with prudent and effective preparedness for emerging infectious diseases. (Yuval Neria, 12/22)