- KFF Health News Original Stories 1
- The Hospital Is In Network, But Not The Doctor: N.Y. Tries New Balance Billing Law
- Political Cartoon: 'But I Play One On TV'
- Campaign 2016 3
- Health Law Repeal-And-Replace Plans Create A GOP 'Dilemma'
- Scott Walker Details Obamacare Replacement Plan Keyed To Tax Credits Based On Age
- In Minn. -- Where Walker Unveiled His Health Care Plan -- Studies Find Premiums Are Lower Than In Wis.
- Public Health 2
- FDA OKs Controversial 'Pink Viagra' For Increasing Women's Libido, Following Two Previous Rejections
- Male Doctors Twice As Likely To Be Sued Than Female Counterparts, Study Finds
- State Watch 4
- California Aid-In-Dying Bill Revived During Special Session, Governor Urges Delay
- Ark. Gov. Reinstates Medicaid Eligibility Verifications, Cancellations
- Rural Hospitals Team Up To Stay Afloat
- State Highlights: Glitch Exposed Health Data For More Than 3,000 Coloradans; Ariz. Fetal-Tissue Reporting Rule Kicks In
From KFF Health News - Latest Stories:
KFF Health News Original Stories
The Hospital Is In Network, But Not The Doctor: N.Y. Tries New Balance Billing Law
Consumers in New York are getting new protections against “balance billing,” where insurers bill patients for the difference between what insurers pay and what providers want, and states considering similar laws are watching closely. (Elana Gordon, WHYY, 8/19)
Political Cartoon: 'But I Play One On TV'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'But I Play One On TV'" by Edgar Argo.
Here's today's health policy haiku:
GOP ON HEALTH CARE: GOALS, POLICIES SOUND FAMILIAR
Repeal and replace…
Just another day, but now
On the campaign trail.
- 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:
Health Law Repeal-And-Replace Plans Create A GOP 'Dilemma'
The Washington Post reports on how the Republican presidential candidates are wrestling with their messages. Meanwhile, John Kasich plans to keep one key portion of the health law, and Marco Rubio talks about health care during his Iowa soapbox speech.
The Washington Post:
Republicans’ Obamacare ‘Repeal And Replace’ Dilemma Joins Presidential Contest
For Republican leaders, one loaded phrase represents the difference between the party they are and the party they wish to be: “repeal and replace.” Since 2010, Republicans have pledged to repeal and replace President Obama’s Affordable Care Act — promising a legislative backflip that would please conservatives who despise the law’s every word and moderates who want to keep some of its benefits. (Fahrenthold and Johnson, 8/18)
CBS News:
John Kasich Explains The Part Of Obamacare He'd Keep
Ohio Gov. John Kasich, a candidate for the 2016 Republican presidential nomination, has a plan to replace the Affordable Care Act, but there's one part of the controversial health care law that he'd keep. "You shouldn't be able to lose your health care because of a pre-existing condition," Kasich told CBS News Chief White House Correspondent Major Garrett. "That's really, really critical." (8/18)
USA Today/The Des Moines Registers:
Rubio Calls For Reformed Economic Policies In Iowa Soapbox Speech
[Florida Sen. Marco] Rubio said America must fully utilize its energy resources — and repeal and replace Obamacare with a health care law that allows every American to buy health insurance, with pre-tax money, from companies from any state. (Ryan, 8/18)
Scott Walker Details Obamacare Replacement Plan Keyed To Tax Credits Based On Age
The plan unveiled by Walker, the first top-tier GOP presidential hopeful to offer such specifics, would also -- among other things -- seek to hold down health care costs by reducing industry regulation, providing block-grants in the Medicaid program and allowing consumers to buy health insurance across state lines.
The Washington Post:
How Scott Walker Proposes To Repeal And Replace Obamacare
GOP presidential hopeful Scott Walker has long said he wants to repeal President Obama's signature Affordable Care Act, but on Tuesday morning he detailed how he would replace the law. Walker's health care plan calls for lowering the cost of health insurance by reducing regulation of the industry, providing tax credits to offset the cost of private insurance plans and allowing people to shop for plans across state lines. He also wants to restructure Medicaid, the government-provided health insurance for the poor and disabled. (Johnson, 8/18)
The New York Times:
Scott Walker’s Health Care Plan Relies On Tax Credits To Buy Coverage
The credits would be based on age, and consumers could then decide what plan to purchase, if they opt to buy health insurance at all. “On my very first day as president of the United States, I will send legislation to the Congress to once and for all repeal Obamacare entirely,” Mr. Walker said in a speech in Minnesota. (Rappeport, 8/18)
The Wall Street Journal:
Scott Walker Unveils Health-Care Plan
“It’s all about freedom,” Mr. Walker said Tuesday while introducing his proposal at a campaign event in Minnesota. “Putting freedom back in the hands of patients and families to make decisions about your health care and about your money.” Mr. Walker said his plan is akin to a “tax cut of about a trillion dollars. (Epstein and Armour, 8/18)
Politico:
Scott Walker Lays Out Obamacare Replacement Plan
Scott Walker became the first top-tier Republican candidate Tuesday to release a plan to replace Obamacare, but conservative rivals said it is too liberal and would create a new entitlement. ... Speaking at a machine parts shop outside of Minneapolis, Walker also said he would sign an executive order to undo what he calls the “special deal for Congress,” which allows the federal government to pay a portion of Hill staffers’ and members’ health insurance as their employer. The provision has raised the ire of conservatives but repealing it would raise insurance costs for staffers on Capitol Hill. (Haberkorn and Cheney, 8/18)
Los Angeles Times:
Scott Walker Sides With Trump On Immigration And Offers Alternative To Obamacare
Walker’s proposal to repeal and replace President Obama’s healthcare law hews to general conservative ideas for expanding health coverage with Medicaid block grants to states and a simplified system of federal aid to Americans to buy insurance. But the plan lacks many key details, including specifics on how it would be paid for. Any healthcare law that offers subsidies to tens of millions of Americans for health coverage, as Walker proposes to do, would probably cost hundreds of billions of dollars. (Bierman and Levey, 8/18)
The New York Times:
Scott Walker To Increase Attacks On Washington
And Mr. Walker noted, in the course of previewing his Tuesday health care speech, that he refused to expand Medicaid in Wisconsin with money offered by the Affordable Care Act. He noted that “a couple of the other governors in this race went the opposite direction.” (Martin, 8/18)
USA Today:
Scott Walker Unveils Health Insurance Plan
Wisconsin Gov. Scott Walker assailed Republicans in Congress on Tuesday for failing to repeal Obamacare while unveiling his own plan to repeal and replace the law. The GOP presidential candidate, who has been lagging in recent polls, decried GOP leaders in Washington who have had control over both chambers of Congress since January but have yet to send a bill to President Obama getting rid of the health care law. (Slack, 8/18)
CNN:
Walker's Health Care Plan: Repeal Obamacare, Replace It With Conservative Alternative
He cast his plan, Tuesday, in terms of a broken promise from Congressional Republicans to repeal Obamacare. "People all across this country are fed up with Washington, I feel your pain, I'm fed up with Washington, too," Walker said. "I think about this, we were told by Republican leaders during the campaign cycle last year that we just needed a Republican Senate to be elected to repeal Obamacare. Well here we sit, you know both chambers of the United States Congress have been controlled since January by Republicans and yet there's not a bill on the president's desk to repeal Obamacare." (LoBianco, 8/18)
Reuters:
Republican Walker Proposes Health Tax Credits By Age, Not Income
Another candidate, Louisiana Governor Bobby Jindal, who laid out his healthcare policy ideas last year, criticized Walker's plan. He said Walker was accepting the premise of Obamacare and "merely quibbling over the details." (Heavey, 8/18)
Local news outlets offered varying takes on GOP presidential candidate Scott Walker's detailed Obamacare replacement plan. He outlined his approach in Minnesota, the state next door to his home state of Wisconsin.
The Minneapolis Star-Tribune:
Gov. Walker Tours Brooklyn Center Machine Shop, Touts Obamacare Replacement
Wisconsin Gov. Scott Walker proposed a replacement to President Obama’s health care law Tuesday at a Brooklyn Center machine shop, using an important policy speech to establish an early political foothold in a neighboring state he hopes can boost his Republican presidential prospects. ... Walker noted how, as Wisconsin governor, he rejected federal Medicaid dollars offered under the new law, and increased the income threshold under which a family of four is eligible for coverage under Medicaid. Over the same period, Minnesota, under DFL Gov. Mark Dayton, has increased public coverage availability for low-income residents. (Condon, 8/18)
Minnesota Public Radio:
Walker Says His Health Plan Puts Families 'Back In Charge'
When Wisconsin Gov. Scott Walker came to Minnesota to unveil his alternative to the Affordable Care Act, he did not mention that health premiums are a lot lower in Minnesota than they are in Wisconsin. (Zdechlik, 8/19)
The Milwaukee Journal-Sentinel:
Scott Walker Unveils Health Care Plan, Emphasizing Obamacare Repeal
Wisconsin Gov. Scott Walker vowed Tuesday to seek a replacement for President Barack Obama's signature health care law on his first day in the White House, trying to draw a sharp contrast with Republicans in Congress who have yet to act on a repeal. (Spicuzza and Stein, 8/18)
Alaska Lawmakers To Seek Court's Help In Blocking Governor's Medicaid Expansion Plan
Implementation of Gov. Bill Walker's plan was set to begin Sept. 1. Some lawmakers, though, are seeking a temporary restraining order to block it while a larger issue -- whether the governor has authority to accept federal funds for the expansion without a vote by the legislature -- is decided. Meanwhile, in Utah, supporters of expansion continue to push for action.
Alaska Public Radio:
Alaska Lawmakers Vote To Sue Over Gov. Walker’s Medicaid Expansion Plan
Walker planned to begin implementing the expanded program on Sept. 1, but lawmakers will ask a judge to put a temporary halt in place until the courts can decide a bigger question — whether the governor has the authority to accept federal funds for the expansion without a vote of the Legislature. In the 10-1 vote Tuesday, Democrat Rep. Sam Kito was the only lawmaker on the Legislative Council who voted not to sue. Senate Majority Leader John Coghill (R-North Pole) said the governor has violated the state constitution by acting independently. (Maxwell, 8/18)
Alaska Dispatch News:
Alaska Legislature Will Sue Gov. Walker To Block Medicaid Expansion
The Alaska Legislature on Tuesday said it will sue Gov. Bill Walker to block his move last month to expand the public Medicaid health care program without lawmakers’ approval. Following a private discussion Tuesday morning, a Republican-controlled House-Senate committee voted 10-1 to spend up to $450,000 on two law firms to represent the Legislature in a suit against the governor. (Herz, 8/18)
The Associated Press:
Lawmakers Vote To Sue Governor Over Medicaid Expansion Plan
A committee of House and Senate lawmakers voted Tuesday to sue Gov. Bill Walker over his effort to expand Medicaid in Alaska, with Republican legislative leaders calling it a separation-of-powers issue. The Legislative Council vote followed a closed-door executive session in Anchorage. The vote was 10-1, with Rep. Sam Kito III, D-Juneau, dissenting. Walker called the council's actions disappointing and said he is not wavering in his position. Walker moved to expand Medicaid coverage to people ages 19 to 64 who are not caring for dependent children, not disabled and not pregnant, and who earn up to 138 percent of the federal poverty level. (Bohrer, 8/19)
Salt Lake Tribune:
Utah Dems Urge Resolution On Medicaid Coverage Gap With Film ‘Donut Hole’
Utah Democrats told Hirsche's story and others' at a news conference Tuesday in an effort to prod Gov. Gary Herbert and Republicans in the Legislature to reach a resolution before the next legislative session starts in January 2016 — and to do it out in the open, rather than behind closed doors. Democrats blame the so-called "Gang of Six" — including Herbert, Lt. Gov. Spencer Cox and GOP lawmakers — for failing to reach a deal to expand Medicaid under the Affordable Care Act. The group missed a self-imposed July 31 deadline. And although the gang's members say they hope to reach a deal before the 2016 Legislature opens, Democrats worry that may be too late for some Utahns who don't make enough to pay for subsidized health care, but make too much to qualify for Medicaid. (McDonald, 8/18)
Deseret News:
Democratic Leaders Frustrated Prison Move, Not Medicaid Expansion On Special Session Agenda
Democratic leaders expressed frustration that lawmakers are being called into a special session Wednesday to deal with relocating the state prison but not what they called a life-and-death issue: Medicaid expansion. "It says that economic development is taking priority over the lives of our citizens of Utah. And that shouldn't be the case," Utah Democratic Party Chairman Peter Corroon said. (Riley Roche, 8/18)
In other news about Medicaid expansion -
CQ Healthbeat:
Study Ties Medicaid Expansion To Mental Health Services
The 19 states that have chosen not to expand Medicaid under the health care law could be hindering their abilities to care for those living with mental illnesses, according to a Psychiatric Services in Advance report. If all the states undertook an expansion by 2020, health centers would have nearly $230 million in additional revenue, according to the report. On top of that, the study found nationwide expansion could provide an estimated $11.3 million for mental health services and $1.6 million for substance abuse services that year. (Evans, 8/18)
Meanwhile, on the topic of the health law and insurance coverage -
The Connecticut Mirror:
Thousands Of Obamacare Customers At Risk Of Losing Coverage Or Subsidies
More than 7,000 customers of Connecticut’s health insurance exchange must provide additional documentation to maintain their coverage or the tax credits that subsidize their premiums – a process that has already led to confusion and, in some cases, lost coverage or subsidies, exchange CEO Jim Wadleigh said Tuesday. (Levin Becker, 8/18)
Wal-Mart Says Fewer Prescription Drug Customers Paying Cash Hurt Its Earnings
The large retailer says its second quarter earnings were affected by the health law. Elsewhere, Medicare plans to buy cheaper biotech drugs when they come on the market, and Amgen settles with states for $71 million over off-label marketing claims.
The Wall Street Journal:
Wal-Mart Margins Hurt by Affordable Care Act
Wal-Mart Stores Inc.’s took a hit from the Affordable Care Act during the second-quarter. The Bentonville, Ark.-based retailer said its pharmacy business had reduced margins, which hurt earnings at the U.S. business. Much of that was due to fewer customers paying for drugs with cash, which has higher margins, said Greg Foran, head of Wal-Mart’s sprawling U.S. operations. Fewer cash payments reflect “a marketplace shift in which more customers are now benefitting from greater drug insurance coverage,” he said, during a pre-recorded earnings conference call. (Monga, 8/18)
CQ Healthbeat:
Biotech Drugs Trigger Medicare Payment Tempest
With biotechnology drugs generating an estimated $60 billion in annual sales set to have lost patent protection by the end of next year, Medicare's plans to buy lower cost, copycat versions of the medicines are becoming a hot topic for patient advocacy groups and some in Congress, Administrators of the big health program are in the midst of staking out reimbursement policies for so-called biosimilars, with a 2016 payment rule for physicians serving as one of the chief vehicles. The Food and Drug Administration in March approved the first such product for sale in the United States: a Novartis AG copy of Amgen Inc.’s Neupogen, for helping people on chemotherapy fight infections. (Young, 8/18)
The Wall Street Journal:
Amgen Reaches $71 Million Settlement With States
Amgen Inc. reached a $71 million settlement with 48 states related to allegations that the biotechnology company made unsubstantiated marketing claims about blockbuster drugs Aranesp and Enbrel, according to several state attorneys general. In a statement on Tuesday, Amgen said the settlement with the states resolves some of the same issues addressed in Amgen’s December 2012 settlement with the federal government related to the company’s marketing practices. (Stynes, 8/18)
Los Angeles Times:
Amgen To Pay $71 Million To States For Promoting Off-Label Drug Uses
Amgen Inc. has agreed to pay $71 million to settle allegations by 48 state attorneys general that it improperly marketed two of its blockbuster drugs. The agreement announced Tuesday brings an end to a difficult chapter in the history of the Thousand Oaks biotech, which pleaded guilty in 2012 to a federal criminal charge related to similar allegations and paid $762 million in criminal penalties and civil settlements. (Pfeifer, 8/18)
FDA OKs Controversial 'Pink Viagra' For Increasing Women's Libido, Following Two Previous Rejections
Supporters of the drug, called Addyi, praised the agency's decision as an end to “gender bias” toward women's sexual needs. Critics say the medication is only a “mediocre aphrodisiac” with significant side effects like low blood pressure, fainting, nausea, dizziness and sleepiness, especially when taken with alcohol.
The Washington Post:
FDA Approves Controversial Drug For Women With Low Sex Drives
The approval of the controversial drug, flibanserin, which the FDA twice rejected before and now will be marketed as Addyi, comes with a series of conditions reflecting the agency’s concerns about serious side effects. These include a boxed warning that highlights the risks of low blood pressure and fainting in patients who drink alcohol while taking the drug, as well as a requirement that doctors complete a training course before being allowed to prescribe it. (Schulte and Dennis, 8/18)
The New York Times:
F.D.A. Approves Addyi, A Libido Pill For Women
The drug — Addyi from Sprout Pharmaceuticals — is actually the first drug approved to treat a flagging or absent libido for either sex. Viagra and other drugs available for men are approved to help achieve erections, or to treat certain deficiencies of the hormone testosterone, not to increase desire. (Pollack, 8/18)
Los Angeles Times:
As FDA Approves 'Pink Viagra' For Women, Controversy Persists
The decision follows a public campaign challenging the agency to close a widening gap between the number of drugs available for men’s sexual health and those available to women. ... Clinical trials presented to the FDA showed that compared with pre-menopausal women who got a placebo, those who took flibanserin reported a modest but measurable rise in sexual desire and increased their number of “sexually satisfying encounters” by roughly one per month, from a median of two to three to between 2 1/2 and four. (Healy, 8/18)
NPR:
FDA Approves First Drug To Boost Women's Sexual Desire
The controversial decision was hailed by some doctors and advocates as a long-sought victory for women's health, but was condemned by others as irresponsible and dangerous. ... The medicine is to be taken daily to treat premenopausal women suffering from hypoactive sexual desire disorder, which is essentially a sudden, unexplained loss of any desire to have sex. (Stein, 8/18)
Politico:
FDA Approves 'Female Viagra' Drug
But the agency’s decision on Tuesday — which follows a well-orchestrated advocacy campaign financed by the drug’s maker, Sprout Pharmaceuticals — comes with a requirement that the company take steps to ensure doctors prescribe flibanserin carefully and make women aware of its health risks. (Karlin, 8/18)
McClatchy:
FDA Approves First-Ever Drug For Women With Low Sexual Desire
“It’s not for everybody,” said Dr. Lisa Larkin, director of the women’s health center at the University of Cincinnati. “Not all women who have low desire have a biologic basis. We understand that very clearly. But there’s a subgroup of patients where biology really is the issue and it’s that group of patients who will be candidates for this medication.” Addyi can cause a severe drop in blood pressure and a loss of consciousness, risks that increase when taken with alcohol and other medications that impede the drug’s breakdown in the body. (Pugh, 8/18)
The Associated Press:
Q&A: First Pill Approved To Boost Sex Drive In Women
Federal health officials on Tuesday approved the first-ever prescription drug intended to treat women suffering from a lack of sexual desire, ending a vigorous debate over the drug's fate. ... Here's a look at the new drug from Sprout Pharmaceuticals. (8/18)
The Associated Press:
Drug Execs Behind Female Libido Pill Have Run Afoul Of FDA
A small drugmaker from North Carolina may succeed next week where many of the world's largest pharmaceutical companies have failed: in winning approval for the first drug to boost women's sexual desire. The husband-and-wife team that founded Sprout Pharmaceuticals is not new to the pharmaceutical business or even to marketing drugs to people frustrated with their sex lives. The couple's previous company, Slate Pharmaceuticals, sold an implantable testosterone pellet to men with low levels of the hormone. But Slate's marketing push ran afoul of federal rules, making misleading, unsupported statements about the benefits of testosterone therapy while downplaying risks. In fact, when the Food and Drug Administration held a meeting examining the overprescribing of testosterone last year, it played Slate's commercial as an example of inappropriate marketing. That record worries Sprout's critics, who see a troubling pattern in the aggressive tactics it has used to urge the FDA to approve the women's desire drug, which was previously rejected twice because of lackluster effectiveness and side effects such as nausea, dizziness and fainting. (Perrone, 8/18)
Male Doctors Twice As Likely To Be Sued Than Female Counterparts, Study Finds
In other legal news, the thousands of lawsuits by women against pelvic mesh makers are attracting medical funders trying to capitalize on the court awards.
The Washington Post:
Male Doctors Are More Likely To Be Sued Than Females, Study Finds
Male doctors are more than twice as likely to have legal action taken against them than their female counterparts, a recent study found. The study, published last week in the journal BMC Medicine, affirms a well-established trend for the first time on a global level. It also shows that the disparity has not changed over the course of 15 years, despite a growing presence of women in the field. (Gebelhoff, 8/18)
Reuters:
Investors Profit By Funding Surgery For Desperate Women Patients
In July 2013, California urogynecologist Andrew Cassidenti received an email from an entrepreneur named Otto Fisher, who had a proposition. Fisher was looking for surgeons to perform operations to remove pelvic mesh implants from women. Intrigued, Cassidenti responded. In a phone call, Fisher said he needed doctors to operate at outpatient centers in California and Las Vegas. Fisher said he could guarantee Cassidenti $2,500 for every surgery the doctor performed, “whether it took five minutes or two hours,” or even if the doctor did not remove any mesh, according to the surgeon’s sworn court statement recounting the conversation. (Frankel and Dye, 8/18)
California Aid-In-Dying Bill Revived During Special Session, Governor Urges Delay
The legislation, which would allow doctors to prescribe life-ending drugs to terminally ill patients, stalled earlier this year. Using a legislative maneuver, however, lawmakers introduced the bill in the Assembly’s special session called by Gov. Jerry Brown to deal with rising costs in the state’s Medi-Cal program.
The Associated Press:
California Governor Balks At Push To Eye Right-To-Die Bill
California lawmakers on Tuesday announced a second attempt at passing right-to-die legislation this year after an earlier measure stalled amid religious opposition and hesitant Democrats. The new bill allowing doctors to prescribe terminally ill patients life-ending drugs was introduced in a special legislative session on health care financing convened by Gov. Jerry Brown. (Nirappil, 8/18)
The San Francisco Chronicle:
Bill To Legalize Aid In Dying In California Revived By Supporters
California lawmakers revived legislation Tuesday that would allow doctors in the state to prescribe life-ending drugs to terminally ill patients who wish to hasten their deaths. (Gutierrez, 8/18)
Reuters:
Top California Lawmakers Vow To Push Aid-In-Dying Bill
California lawmakers on Tuesday reintroduced a bill to legalize assisted suicide that had stalled amid opposition from the Catholic church and disability rights activists, as leaders among majority Democrats vowed to make its passage a priority. In a move that made clear that lawmakers sought support from Latino Catholics who might be concerned about church opposition, backers of the bill showcased support from top Latino politicians at a news conference on Tuesday, some of whom spoke dramatically in Spanish of the pain and suffering experienced by people with terminal cancer and other illnesses. (8/18)
Ark. Gov. Reinstates Medicaid Eligibility Verifications, Cancellations
Despite numerous complaints that people who qualify are being kicked off the program, Gov. Asa Hutchinson said Arkansas will resume its effort to cease coverage for Medicaid beneficiaries who haven't verified their incomes. Meanwhile, Ariz. Gov. Doug Ducey is continuing to talk up his plan to tighten some eligibility requirements.
The Associated Press:
Asa Hutchinson: Medicaid Cancellations To Resume
Arkansas will resume its push to terminate coverage for thousands of Medicaid beneficiaries who haven't verified their income, Gov. Asa Hutchinson said Tuesday, despite complaints that many being kicked off the program still qualify. Hutchinson said the Department of Human Services has eliminated a backlog of responses from Medicaid recipients trying to prove they still qualify for coverage. The Republican governor had ordered a two-week pause in the terminations so DHS officials could process thousands of responses they had received. (DeMillo, 8/18)
Arkansas Online:
Governor Reinstates Medicaid Verifications, Terminations
Arkansas will lift the suspension on Medicaid verifications and terminations, Gov. Asa Hutchinson said Tuesday during a news conference at the state Capitol. In addition, an agreement has been reached to provide pharmacy benefits for 30 days to certain individuals covered by two insurance carriers — Blue Cross Blue Shield and Centene — who have been sent a notice of termination. (Riddle, 8/18)
The Arizona Republic:
Gov. Ducey Plan To Retool Medicaid Criticized At Public Hearing
Gov. Doug Ducey’s plan to tighten eligibility requirements for some enrolled in Arizona’s Medicaid program drew questions and concerns at a public meeting Tuesday. Critics said it would harm access to care for low-income residents with no evidence that it would save taxpayers money. (Alltucker, 8/18)
News outlets from California, Kentucky, Ohio and Pennsylvania also report on Medicaid developments -
California Healthline:
Feds OK State's Drug Medi-Cal Waiver
CMS officials last week approved California's Drug Medi-Cal waiver, opening the door for the state to dramatically change the way mental health services are delivered in Medi-Cal. (Gorn, 8/18)
Columbus Dispatch:
State Releases Report Card On Medicaid's Managed-Care Plans
All five managed-care plans serving poor and disabled Ohioans on Medicaid score average when it comes to how happy patients are with their doctors. Medicaid officials released the state’s first report card of managed-care plans on Tuesday. It’s a tool they hope will help beneficiaries choose coverage that works best for them and their families. (Candisky, 8/18)
The Associated Press:
Kentucky's Medicaid Population Centered In East
A new review by a nonprofit health organization shows that the largest share of Kentucky's Medicaid population lives in the impoverished eastern portion of the state. The Foundation for a Healthy Kentucky has embarked on a three-year study of how the federal Affordable Care Act is affecting Kentucky. The group released its first report on Tuesday. About a quarter of the state's population is now on Medicaid after the state decided to expand the program's eligibility requirements. Eastern Kentucky accounts for 32 percent of the Medicaid recipients while 25 percent live in western Kentucky. Nineteen percent live in Louisville, 16 percent live in Lexington and 8 percent live in northern Kentucky near Cincinnati. (8/19)
The Philadelphia Inquirer:
Philadelphia Health Insurer Selected To Sell Medicaid Coverage In Iowa
A subsidiary of Philadelphia-based AmeriHealth Caritas was one of four companies selected by Iowa officials to participate in the management of the state's $4.2 billion Medicaid program, which serves about 560,000, officials announced Tuesday. AmeriHealth and the other winners - units of Anthem Inc., UnitedHealth Group Inc., and WellCare Health Plans Inc. - will compete statewide for Medicaid beneficiaries under the program, which starts Jan. 1, 2016. Iowa officials picked four of 10 health insurer applicants that completed the process. (Brubaker, 8/19)
Rural Hospitals Team Up To Stay Afloat
Facing less money and patients with more health needs, hospitals outside cities are joining forces. Elsewhere, Alaska's two biggest hospitals fight over ER beds and a Dallas hospital's move is scrutinized. In Missouri, a mental hospital expands services to protect gender identity, and advocates for a Florida woman with mental illness try to secure care for her.
Stateline:
To Survive, Rural Hospitals Join Forces
Ask Sam Lindsey about the importance of Northern Cochise Community Hospital and he’ll give you a wry grin. You might as well be asking the 77-year-old city councilman to choose between playing pickup basketball—as he still does most Fridays—and being planted six feet under the Arizona dust. Lindsey believes he’s above ground, and still playing point guard down at the Mormon church, because of Northern Cochise. Last Christmas, he suffered a severe stroke in his home. He survived, he said, because his wife, Zenita, got him to the hospital within minutes. If it hadn’t been there, she would have had to drive him 85 miles to Tucson Medical Center. (Ollove, 8/18)
Alaska Dispatch News:
Anchorage Hospitals Appeal State's ER Bed Cap
Anchorage's two largest hospitals are continuing their struggle over the limited share of emergency room beds that can be built in the next several years, with both Alaska Regional Hospital and Providence Alaska Medical Center filing appeals over the state's recent allocation decision. An oversupply of emergency room beds tends to push up health care costs, so most U.S. states, including Alaska, have laws limiting the capacity of emergency rooms, as well as other medical services and facilities. Until the year 2022, no more than 13 beds can be added anywhere in the Municipality of Anchorage, according to the state Department of Health and Human Services. (Falsey, 8/17)
The Dallas Morning News:
Parkland Memorial Hospital In Dallas Still Under Review
When Parkland Memorial Hospital moves across Harry Hines Boulevard, it will bring along about 600 patients, 11,000 employees and countless pieces of medical equipment. What hospital leaders don’t want to transport is the controversy that has dogged Dallas County’s public hospital for the past four years. That will be impossible. While Parkland satisfied many of the issues that threatened its federal funding, it remains under continued scrutiny by the federal government. The Dallas County public hospital is two years into a five-year corporate integrity agreement that has focused on billing problems and patient-safety concerns. (Jacobson, 8/18)
St. Louis Public Radio:
Fulton State Hospital's Non-Discrimination Policy Includes Gender Identification
Missouri's only state-run mental hospital has updated its non-discrimination practices to include gender identity. That's despite the fact that Missouri's legal definition of discrimination does not include or protect sexual orientation or sexual identity. Marty Martin-Forman is chief operating officer for Fulton State Hospital. She says their transgender patients provided the inspiration to make internal policy changes. (Griffin, 8/19)
The Miami Herald:
Locked In Hospital, Woman Caught In Baker Act Fight
For much of Cindy Mertz’s tormented childhood, temper tantrums were a reliable method for coping with starvation, filth and abuse. But the screaming and foot-stomping that sometimes worked for a child have wrought terrible consequences for 21-year-old Mertz, who remains intellectually disabled. Three weeks ago, Mertz landed inside a locked Pasco County mental hospital. Her legal guardian has repeatedly demanded that she be released back to a state-funded group home where staff has learned to manage her behavior. The hospital has repeatedly refused. When a family advocate accused the hospital of “kidnapping” Mertz, staff blocked the advocate’s email account. And when a behavior analyst who had worked with Mertz for three years complained that her stay at North Tampa Behavioral Health was making her condition worse, the facility blocked his email, too. (Miller, 8/18)
Health care stories are reported from Colorado, Arizona, Minnesota, New York, South Dakota, Maine, Missouri and New Mexico.
The Denver Post:
Colorado Breach Exposes Personal, Health Data For 3K Clients
A computer glitch exposed protected health data or personal information for more than 3,000 Colorado residents who receive state health benefits, Gov. John Hickenlooper's administration revealed Monday. The confidential information was disclosed in letters mailed to wrong addresses between May 25 and July 5 — the second data breach this year involving the Colorado Benefit Management System, the troubled computer system that distributes aid to needy residents. Colorado officials are sending notices to those whose information was disclosed and asking those who received the errant letters to destroy the document. (Frank, 8/17)
The Arizona Republic:
New Arizona Fetal-Tissue Reporting Rule Takes Effect
Arizona abortion clinics must report to state health officials what happens to the remains of aborted fetuses, under a new temporary rule ordered by Gov. Doug Ducey and approved by Attorney General Mark Brnovich. If the fetal tissue is transferred to another person or entity, except for a funeral home or crematory, health officials must also disclose the identity, any compensation received for the tissue, and whether the patient agreed to the transfer. The questions have been added to forms that clinics are required to file with state health officials. (Sanchez, 8/17)
The Associated Press:
UCare Looks To Salvage State Contracts For Public Programs
A Minnesota health insurance company started a public push on Tuesday to maintain its foothold in the state’s public programs. Minnesota contracts with health plans to cover low-income residents on MinnesotaCare and Medical Assistance. A new statewide competitive bidding process is slated to leave out UCare, forcing its 360,000 consumers to pick a new plan and costing the company a sizable portion of its business. (Potter, 8/18)
Kaiser Health News:
The Hospital Is In Network, But Not The Doctor: N.Y. Tries New Balance Billing Law
He thought it was pneumonia. Michael Trost, 52 and seemingly healthy, just wasn’t feeling right. During a chance break at work as a wood finisher, Trost’s wife brought him to an emergency room near where they live at the edge of the Poconos in Dingmans Ferry, Pa. "They’ll give me a chest x-ray and antibiotics and I’ll be on my way," Trost thought. (Gordon, 8/19)
The Associated Press:
Embedded In Colony Life, South Dakota Nurse Transforms Health Care For State's Hutterites
A spaghetti dinner with people in prairie dress and a church service in German is all in a day's work for Kerri Lutjens. The 33-year-old nurse, who doesn't speak German, has spent the past few years gaining the trust of several communities of Hutterites, a deeply religious people with ancestral ties to the Amish who live in insular farming communities in the Plains, Upper Midwest and Canada. Although she provides a broad range of care to the eight South Dakota Hutterite colonies she serves, Lutjens has paid particular attention to vaccinating children in these communities and preventing outbreaks like one in Ohio last year in which 383 people, most of them unvaccinated Amish, got the measles. (Burbach, 8/18)
The Associated Press:
Law Enforcement, Health Care Officials Coming Together This Week To Tackle Maine's Drug Crisis
Nearly two dozen of Maine's top law enforcement and health care officials are joining Republican Gov. Paul LePage this week to develop strategies for combating the state's drug epidemic. Among those expected to attend Thursday's drug summit are Brig. Gen. Gerald Bolduc of the Maine National Guard, Roy McKinney, director of the Maine Drug Enforcement Agency and Bruce Campbell of the Bangor Area Recovery Network. (8/19)
St. Louis Public Radio:
Durbin: Drug Abuse Doesn't Mean Going 'Through Jail Every Time'
U.S. Sen. Dick Durbin provided a fairly blunt reply to the proposition that the War on Drugs failed. “By some measure, it has failed,” said Durbin, D-Ill. “If the measure is the cost of drugs on the street, it has failed. But when we look at the individual lives saved, there are certainly heroic great stories to be told. But we have to be honest about what works and what doesn’t.” Before hosting a roundtable discussion Monday in Granite City on heroin abuse, Durbin extolled the virtues of drug treatment –- and the increasing availability of drugs like Naloxone that reverses a heroin overdose. (Rosenbaum, 8/17)
The Associated Press:
NY Expands Colorectal Cancer Screening With Federal Money
New York is using $8 million in federal funding to expand screenings for colorectal cancer. Gov. Andrew Cuomo's office announced the move on Monday. The Democratic governor's office says the state sees nearly 10,000 new cases of the disease and 3,000 colorectal cancer deaths each year. The expanded screening program will focus on underserved and high-need areas in New York City, Syracuse, Buffalo, Rochester and the North Country. The screenings will be carried out by local health care providers. The money will also support efforts to promote screenings, which Cuomo notes can help doctors identify colorectal cancer early enough for successful treatment. (8/18)
The Albuquerque Journal:
Nursing Home Being Sued By AG Sues Back
A nursing home being sued by Attorney General Hector Balderas has filed a lawsuit alleging Balderas has violated the state’s public records law by refusing to release communications between his office and two out-of-state law firms working with the AG. In the lawsuit filed in state District Court in Albuquerque, Bloomfield Nursing Operations LLC alleges Balderas’ office has either improperly denied or partly denied the company’s requests for documents, or has not produced them in a reasonable amount of time as required by the state Inspection of Public Records Act. (Baker, 8/18)
Viewpoints: GOP Candidates' Health Plans Shift Benefits; Kasich's Moderate Stance Debated
A selection of opinions on health care from around the country.
The Wall Street Journal:
The Post-ObamaCare Debate Begins
We interrupt the Donald J. Trump summer jam for something slightly more substantive: the emerging debate in the Republican field about how to wind down ObamaCare and repair health-care markets. Scott Walker rolled out a pragmatic center-right plan on Tuesday, and the other candidates ought to follow the Wisconsin Governor’s lead with their own proposals. (8/18)
The New York Times' The Upshot:
Health Proposals By Walker And Rubio Are Less Concerned About The Poor
Obamacare gives federal money to poor people to help them get health insurance. Scott Walker, Wisconsin’s governor, has a replacement plan. It would give federal money to old people instead. There are many, many other differences between Obamacare and Mr. Walker’s plan, announced Tuesday in a white paper and a policy speech. But that difference points to the key similarity between the plans, and the most consequential change. (Margot Sanger-Katz, 8/18)
Bloomberg:
Republicans' Obamacare Alternative, Finally
Obamacare promised that it was for the middle class. In practice, it has overwhelmingly been a program for the poor and near-poor. Its two main features were a Medicaid expansion for everyone earning up to 133 percent of the federal poverty line and exchange policies for anyone else who wasn't eligible for employer insurance or another government program. As it turns out, exchange policies have been extremely popular among people whose policies are heavily subsidized, but not so popular with anyone who has to pay a significant chunk of the bill. This was basically a poverty program that was sold by playing to the anxieties of middle-class people worried about losing their health insurance. The Republican plan is, in fact, a program for the middle class. As such, it will be much less generous toward the poor. It will redistribute money upward, from those struggling very hard to ordinary Joes who are not rich, but not quite so desperate either. (Megan McArdle, 8/17)
USA Today:
Scott Walker: Get DC Out Of Our Health Care
ObamaCare was forced on the American people by Democrats who think the government knows best, chief among them, Hillary Clinton. The seeds of this destructive law were first planted by Clinton in the early 90s as part of her failed health care plan, HillaryCare, and in her 2008 campaign’s health care proposal. Although Clinton’s health care proposals failed, many of their central provisions — including the individual mandate and harsh penalties for those who don’t purchase insurance — succeeded in making their way into ObamaCare. (Gov. Scott Walker, 8/18)
Los Angeles Times:
Walker's Healthcare Plan Is Perfect, If You Want Almost No Insurance At All
[Walker's plan offers] every nostrum promoted by the conservative and libertarian lobbies (the Heritage Foundation is cited several times), none of which has been shown to make much of a dent in the nation's population of the medically uninsured and a few of which would work against that goal, is in there. To be fair, Walker threw in a couple of novel curves. Let's take them up first. The most notable is a provision to convert the income-based premium subsidies provided under the Affordable Care Act to a system based on age. According to Walker's breakdown, the subsidies would range from $900 a year for those 0-17 years old, up to $3,000 for those 50-64. The payments are only for those without employer-sponsored insurance. (Michael Hiltzik, 8/18)
The Washington Post's Right Turn:
Walker Unveils Health-Care Plan, New Message
After much hype from his campaign, Wisconsin Gov. Scott Walker unveiled his health-care plan, which — like many of plans out there (including ones like those put out by Sen. Marco Rubio, Rep. Tom Price and Sen. Orrin Hatch) — proposes repealing Obamacare, going to a system of tax credits for those without employer-provided insurance, allowing insurance sales across state lines, high risk pools for the hard-to-insure and block granting Medicaid. Walker did not explain how he is going to pay for it. ... But Walker’s plan just did not seem to live up to the billing. (Jennifer Rubin, 8/18)
The Washington Post:
The GOP’s Deeply Flawed Field
But these “plausible” Republican candidates hold views that are dramatically at odds with interests and values of the vast majority of Americans. ... All would repeal Obamacare without giving us a clue of what would replace it. All want to slash spending on shared security programs like Social Security and Medicare. [Former Florida Gov. Jeb] Bush and [Florida Sen. Marco] Rubio have called for raising the retirement age for Social Security. ... Or consider social issues. [Wisconsin Gov. Scott] Walker and Rubio have both flip-flopped to announce that they now oppose all abortion with no exceptions for rape, incest or to protect the life of the mother. Bush supports the act banning abortions after 20 weeks with exceptions for rape, incest and protecting the mother’s life. (Katrina vanden Heuvel, 8/18)
USA Today:
Myth Of The 'Moderate' John Kasich
As Minority Leader in the Ohio Senate, I can tell you my job would be a whole lot easier if John Kasich were actually a moderate. Yes, Kasich did make the decision to expand Medicaid, and Democrats in Ohio helped him do it. What you don’t hear, though, is that Kasich refused to set up a state-run insurance exchange due to his opposition to Obamacare — an exchange that could have been tailored to the specific needs of Ohioans. (Joe Schiavoni, 8/18)
The Washington Post:
Conservatives Double Down On Pro-Life Extremism
It is becoming difficult to escape the conclusion that conservatives would rather fight about abortion than reduce it. Candidates in this month’s Republican presidential debate tripped over themselves to display their pro-life extremism, disavowing exceptions that would permit abortion in cases of rape, incest or even to save the life of the mother — non-starters all in American public opinion. (Dana Milbank, 8/18)
Alaska Dispatch News:
Legislative Council Decides To Sue Walker Over Medicaid To Protect Checks And Balances
Tuesday, the Alaska Legislative Council, acting on behalf of the legislative branch, voted to file an injunction against the governor for his attempt to expand Medicaid without authorization. The Alaska Constitution is crystal clear: No public funds may be spent outside of the legislative appropriations process. The governor has begun the task of expanding Medicaid by seeking to hire 23 new staff. Administrative costs – just keeping track of the new paperwork burden – will cost millions of state dollars. Having no legal source of cash for this action, the governor has decided to raid the Alaska Mental Health Trust, a fund dedicated to providing care, including substance abuse treatment, to vulnerable Alaskans. We believe his action is unconstitutional and it's simply wrong. (State Sen. Kevin Meyer and State Rep. Mike Chenault, 8/18)
The New York Times:
Help From The Obama Administration For Community Health Centers
The Obama administration last week announced a big increase in support for community health centers in the latest expansion of a program that has a long bipartisan history and robust bipartisan support today. (8/19)
Los Angeles Times:
A Terrorized And Harassed Corporate Partner Abandons Planned Parenthood
Last week a small California company that provides human blood, cells and tissues to research scientists bailed on one of its partners, Planned Parenthood. Placerville, Ca.-based StemExpress, which had worked with Planned Parenthood to distribute fetal cells and tissues following abortions at the organization's clinics -- with the full consent of the patients undergoing the procedure -- ended its relationship with the healthcare provider "due to the increased questions that have arisen over the past few weeks." These aren't questions about the legality or ethics of Planned Parenthood's activities, which haven't been legitimately challenged. They're questions about whether the organization's activities can survive a full-scale political onslaught. (Michael Hiltzik, 8/18)
The Wall Street Journal:
What Post-Katrina New Orleans Shows About Urban And Race Issues
Blacks and whites in New Orleans have very different views of the opportunities available to young people and whether the city is a good place for children to grow up, and the racial divide in how residents view these basic measures is widening. These and other findings of a comprehensive study of New Orleans a decade after Hurricane Katrina highlight the progress that can be made in urban America and the issues underlying our debates about race. (Drew Altman, 8/19)
The Denver Post:
Psychological Counseling Can Be A Valuable Outlet For Some Jurors
We Coloradans owe a debt of gratitude to the jurors who acted on our collective behalf, spending weeks on two gruesome and grueling cases: the Aurora theater shooting trial and the Fero's bar murder trial. In the case of the Aurora theater shooting trial, the Arapahoe County court offered psychological counseling to members of that jury. Bravo. (Ross van Woert, 8/18)