- KFF Health News Original Stories 3
- How Four Words In Huge Health Law Divide The Supreme Court
- Auditor Slams California’s Oversight Of Medi-Cal Plans Used By 9 Million
- Obamacare Ruling Could Kill Coverage For 413,000 In Georgia
- Political Cartoon: 'Make Short Work?'
- Capitol Watch 2
- Congressional Republicans Face King V. Burwell Conundrum
- Rep. Fred Upton Seeks Wide Bipartisan Support Of 'Cures' Bill To Encourage Senate Adoption
- Marketplace 2
- Insurers Ready Merger Deals After Health Law, Managed Care Lull
- Majority Polled Say Prescription Drug Prices Are Too High And Point Finger At Drugmakers
- Public Health 2
- Food Industry Must Phase Out Trans Fats Over Next Three Years
- Updated Birth Control Training For Counselors Cuts Unintended Pregnancies
- State Watch 4
- California Breaks Ground In Offering Health Coverage To Children In U.S. Illegally
- California, Massachusetts Medicaid Programs Blasted
- 'Unacceptable' Numbers Of Pa. Foster Children Take Psychiatric Drugs, Report Says
- State Highlights: Paramedic-Coverage Bill Advances In N.J. Legislature; Mass. Home Care Workers Say Company Is Thwarting Union Efforts
From KFF Health News - Latest Stories:
KFF Health News Original Stories
How Four Words In Huge Health Law Divide The Supreme Court
Here’s a breakdown of the King v. Burwell arguments that challenge and support whether the health law’s tax subsidies can be used to buy insurance through the federal government’s online marketplace. (Stuart Taylor Jr., 6/17)
Auditor Slams California’s Oversight Of Medi-Cal Plans Used By 9 Million
Report finds state health officials had no idea whether managed care plans have sufficient doctors, while an overwhelmed ombudsman’s office failed to answer 12,500 calls a month on average. (Barbara Feder Ostrov, 6/16)
Obamacare Ruling Could Kill Coverage For 413,000 In Georgia
No tax credit means no health insurance at all for tens of thousands of Georgians. (Misty Williams, Atlanta Journal-Constitution, 6/17)
Political Cartoon: 'Make Short Work?'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Make Short Work?'" by Harley Schwadron.
Here's today's health policy haiku:
MAKING CHOICES IN THE DARK
Consumer driven
Doesn't work if none of us
Know what the cost is
- Cathy Shuck
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:
Waiting Game For States, Consumers As Supreme Court Weighs Subsidies
The Obama administration says it has no backup plan if the high court strikes some health law subsidies, but state-based fixes could save coverage for many. In Tennessee, the governor says his state will wait and see before creating a contingency plan. And advocates rally to put pressure on officials to help people keep subsidies.
Bloomberg Business:
With Obamacare In Peril At Court, Government Offers Scant Relief
Millions of Americans could lose their insurance if the U.S. Supreme Court rules against President Barack Obama on his health-care law. And with the decision due in the next two weeks, the government has no backup plan. The court will say whether tax subsidies under Obamacare that make insurance more affordable for 6.4 million people in 34 states are legal. If it decides they aren’t, that would trigger a high-stakes debate between the administration and Congress over how to respond. Most of the states have no answer either. (Sink, 6/17)
Politico:
A State Fix If Court Hits Obamacare?
The White House claims it has no contingency plan if the Supreme Court strikes down Obamacare subsidies in 34 states that rely on HealthCare.gov rather than operate their own exchanges. Congress is so deeply divided that Republicans don’t even agree among themselves on what to do if 6.4 million Americans see the subsidies vanish. That could leave the whole mess up to the states — and they don’t have an easy remedy either. The 34 states would have to figure out how to establish their own exchanges to keep the subsidies flowing. Some red states insist they won’t even try to fix what they think is a Washington problem, meaning the coverage gap between red and blue states could become even deeper. (Pradhan, 6/17)
The Nashville Tennessean:
Haslam: Wait For Supreme Court Before State Exchange Decision
The state is in a holding pattern about whether it would move to set up a state-run health insurance exchange as it waits on the outcome of a U.S. Supreme Court case that threatens tax credits for more than 150,000 Tennesseans. With less than two weeks left in the Supreme Court's annual term when it releases decisions, Gov. Bill Haslam said his administration wants to see what comes down from the nine justices before making future plans. (Fletcher & Boucher, 6/16)
The Arizona Republic:
Health-Law Subsidies At Risk In Supreme Court Case
More than 126,500 Arizona residents could lose health-insurance coverage if the U.S. Supreme Court this month rejects the federal government's method of helping people pay for health insurance. The case, King v. Burwell, examines whether Affordable Care Act subsidies that help offset monthly health insurance premiums are allowed only in marketplaces that are "established by the state." (Alltucker, 6/16)
Politico Pro:
Families USA Ramps Up Campaign To Keep Subsidies
If the Supreme Court strikes down Obamacare subsidies in federal exchanges, 91,000 of Florida Republican Rep. Mario Diaz-Balart’s constituents would lose financial assistance — more than any other congressional district across 14 southern states, according to data released Tuesday by Families USA. (Demko, 6/16)
Elsewhere, KHN looks closely at the language in question in the law, and South Floridians are already losing their coverage over paperwork snafus --
Kaiser Health News:
How Four Words In Huge Health Law Divide The Supreme Court
In an analysis for Kaiser Health News, Stuart Taylor Jr. writes: "The U.S. Supreme Court is poised to issue a decision this month in a case that could again threaten a key aspect of President Barack Obama’s health law. But this time around, unlike three years ago when the court rejected a constitutional challenge to the law’s individual mandate, the case, King v. Burwell, focuses primarily on statutory interpretation." (Taylor, 6/17)
The Miami Herald:
Paperwork Inconsistencies Causing South Floridians, Others To Lose Obamacare Subsidies
Michel River’s application for an Obamacare insurance plan ran smoothly. He signed up with an agent in November, submitted supporting income documents and started paying his monthly premium of $48. That’s why he was surprised a few months later when his health insurer, Molina Healthcare of Florida, charged him $536 — the full cost of one month of insurance without the tax credits that made his plan affordable. (Herrera, 6/16)
Congressional Republicans Face King V. Burwell Conundrum
GOP lawmakers are now feeling health law heat as they wrestle with the challenge of what to do if the Supreme Court strikes down the overhaul's subsidies in states that use healthcare.gov. Party leaders are expected to brief the rank and file about possible plans and courses of action. And, in the meantime, the House is planning a set of health law repeal votes in advance of the decision.
The New York Times:
G.O.P. Is Wary That Health Care Win Could Have Its Own Risks
Republicans who have been hoping that the Supreme Court will upend President Obama’s health care law are now confronting an urgent and uncomfortable question: What if they win? Republicans in Congress would face an enormously complicated challenge to fashion an alternative, and they fear the fallout could lead to election losses if millions of Americans abruptly found themselves without health insurance. (Pear, 6/17)
The Associated Press:
AP Sources: GOP Leaders To Brief Lawmakers On Health Care
House and Senate Republican leaders are ready to tell GOP lawmakers about their proposals for responding to a Supreme Court decision that could abruptly halt federal health care subsidies for millions of people. With justices expected to rule imminently and possibly obliterate a pillar of President Barack Obama's health care overhaul, each chamber's Republican leaders planned separate briefings Wednesday for their party's rank-and-file. (Fram, 6/16)
Politico Pro:
House Plans Obamacare Repeal Votes Ahead Of Supreme Court Decision
House Republicans are planning a strategic set of votes this week on two Obamacare repeal measures that could earn Democratic support ahead of a landmark Supreme Court decision on the health care law. With the votes, Republicans are trying to show they’re willing to work with Democrats on reforms to the health care system as they look to fight off criticism that they can’t agree on a plan to deal with the fallout of a Supreme Court decision wiping out insurance subsidies for millions of Americans. (Mershon, 6/16)
Rep. Fred Upton Seeks Wide Bipartisan Support Of 'Cures' Bill To Encourage Senate Adoption
In other congressional news, Politico examines the House Republicans' budget and finds that increased funding for NIH and the CDC would come at the expense of other domestic programs, including the elimination of the Agency for Healthcare Research and Quality. Lawmakers are also considering a host of other legislative action or policy changes like a mental health bill, allowing grant money to pay for needle exchanges and how to improve electronic health records.
Modern Healthcare:
Upton Aiming 80% Of House Back 21st Century Cures
House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) is aiming to have as many as 350 votes or 80% of the members of the House to back the 21st Century Cures Act, also known as H.R. 6. Upton made the announcement during a Tuesday news conference surrounded by other members of Congress from both sides of the political aisle and patients battling a variety of illnesses including lupus and multiple sclerosis. The bill now has 131 co-sponsors, made up of half Republican and half Democrats. Achieving the 80% goal would send the right signal to the Senate, with the hope that they would quickly pass their own version of the bill, he said. (Dickson, 6/16)
Politico:
NIH Boost Masks GOP Cuts Elsewhere From Obama's Budget
House Republicans rolled out a giant $153 billion spending bill Tuesday that tries to put a kinder, gentler — some say smarter — face on what are still deep cuts from President Barack Obama’s domestic budget. More than in the past, there are clear winners led by the National Institutes of Health together with the Centers for Disease Control and modest new investments in education initiatives targeted to early childhood, disadvantaged minority students and the disabled. (Rogers, 6/16)
CQ Healthbeat:
Revised Mental Health Bill Gets Conditional Endorsement
A revised version of a wide-reaching mental health bill by Rep. Tim Murphy appears to have picked up the tentative support of a group that endorsed a rival measure last year, but Democrats still have concerns about Murphy's effort. The Pennsylvania Republican said some changes will be made to the legislation (HR 2646) and expressed hope that it would be marked up soon after Tuesday’s Energy and Commerce Health Subcommittee hearing. Subcommittee Chairman Joe Pitts, R-Pa., said the panel would act on the legislation, which seemed to get somewhat of a warmer reception than Murphy received at that stage for a similar bill last year. (Attias, 6/16)
The New York Times:
House Republicans Ease Opposition To Needle Exchanges
Faced with a health crisis resulting from a rise in heroin use in many of their home states, House Republicans are easing their longstanding opposition to federal funding in support of needle exchange programs. The annual health spending measure now taking shape in the House would still bar using federal dollars to buy sterile needles or syringes, but officials could use federal grant money to provide support for state and local drug treatment programs that include needle exchanges. (Hulse, 6/16)
CQ Healthbeat:
Electronic Records Limit Docs' Contact With Patients, Panel Is Told
Although electronic health records can improve the quality of care, some health experts warn that overly burdensome documentation requirements are forcing doctors to spend more time on computers at the expense of interacting with their patients. “Complaints of increased time burdens on the practitioner, loss of provider interactions with patients and frustration with new requirements and changed workflows dominated discussion among providers, even as the capability of EHR’s to reduce errors and improve communication had grown,” said Boyd Vindell Washington, president of Unified Medical Group and chief medical information officer of Franciscan Missionaries of Our Lady Health System, told the Senate Health, Education, Labor and Pensions Committee on Tuesday. (Zanona, 6/16)
Insurers Ready Merger Deals After Health Law, Managed Care Lull
The largest U.S. insurers -- UnitedHealth, Anthem, Aetna, Cigna and Humana -- are all looking at combinations for teaming up, but any move faces significant antitrust scrutiny. In the meantime, stocks of UnitedHealth surge on Aetna takeover speculation, with Aetna CEO Mark Bertolini in line to make up to $131 million if he loses his job because of a merger.
The Wall Street Journal:
Insurers Playing A Game Of Thrones
Big U.S. insurers are courting one another for possible multibillion-dollar deals. How they pair off could have significant implications for the managed-care industry, its individual and corporate customers, and U.S. medical providers. Each potential target has strengths in different parts of the managed-care puzzle. (Weaver, 6/16)
Bloomberg News:
Five-Way Dating Drama Spices Up Staid Health Insurers
Deal drama is heating up the world of health insurance. The biggest U.S. providers — UnitedHealth Group, Anthem, Aetna, Cigna and Humana — are all looking at possible combinations. After a two-year lull in managed-care dealmaking, buyers are feeling more comfortable with the implications of the Patient Protection and Affordable Care Act and ready to put cash to work on deals. Humana — with a market value of $30 billion — is the most frequently mentioned target, but where there's one deal, another could follow. No one wants to be left without a partner, knowing that in the end, just three of the big five will likely be left standing. (Sutherland, 6/16)
Modern Healthcare:
Antitrust Scrutiny, Logistics Would Complicate Any Large-Scale Insurer Deal
Aetna, Anthem, Cigna Corp. and UnitedHealth Group have headlined a frenzied round of consolidation speculation among health insurers. But many of the rumored mergers would face significant external and internal hurdles. The sheer size of combined insurance companies would immediately prompt strict review from the Department of Justice, which investigates insurance antitrust cases. Any deal also would be costly and would complicate some companies' stated long-term goals. (Herman, 6/17)
The Minneapolis Star-Tribune:
UnitedHealth Stock Rises On Report Of Aetna Bid
Merger speculation is sweeping through the insurance sector, which stock analysts say is ripe for consolidation. Shares of Minnetonka’s UnitedHealth Group jumped 2 percent Tuesday in reaction to a Wall Street Journal report that it’s made an overture to competitor Aetna. That followed speculation in recent days about several other big health insurers. (Carlson, 6/16)
The Wall Street Journal:
Humana Won’t Get Lost In Merger Shuffle
All of a sudden, Humana isn’t the only health insurer available for sale. That is good news for its would-be buyers, although it doesn’t have to be calamitous for Humana. The U.S. managed-care industry is in a merger-and-acquisitions frenzy as the five largest insurers— UnitedHealth, Anthem, Aetna, Cigna, and Humana—explore a series of possible combinations, according to The Wall Street Journal. (Grant, 6/16)
Bloomberg Business:
Aetna CEO's $131M Parachute Biggest Among Health Targets
Aetna Inc. CEO Mark Bertolini has the most to gain among top executives at the three U.S. health insurers seen as targets in a potential wave of industry consolidation. Bertolini could receive $131.3 million should he lose his job in a takeover, according to data compiled by Bloomberg. Cigna Corp. Chief Executive Officer David Cordani would get $58.7 million, while Humana Inc. CEO Bruce Broussard’s so-called golden parachute is valued at $26.1 million. The five biggest publicly traded insurers are all eyeing potential combinations after a two-year lull in big managed-care deals. Anthem Inc. has explored a takeover of Cigna and Humana, and Aetna and Cigna have considered buying Humana, Bloomberg has reported. The Wall Street Journal has said UnitedHealth Group Inc. might be interested in Aetna or Cigna. (Tracer, Melin and Melby, 6/17)
And millenials have a hard time deciphering health insurance lingo --
NPR:
Defeat By Deductible: Millennials Aren't Hip To Health Insurance Lingo
Young adults, who generally have little experience managing their own health care expenses, are finding it especially hard signing up for insurance under the Affordable Care Act, according to a study published Tuesday in the Journal of Adolescent Health. (Singh, 6/16)
Majority Polled Say Prescription Drug Prices Are Too High And Point Finger At Drugmakers
This issue is also being examined by Politico, which convened a group of doctors, insurance and drug lobbyists, policy makers and patient advocates to discuss possible solutions and options. And the Philadelphia Inquirer profiles the chair of the University of Pennsylvnia's department of medical ethics and health policy, who has been speaking out on controlling drug costs.
The Fiscal Times:
Paying Too Much For Your Meds? Americans Blame Drug Companies
The vast majority of Americans believe that drug prices are unreasonably high, and point to pharmaceuticals firms’ outsized profits as the reason, according to the Kaiser Family Foundation’s Health Tracking Poll. The poll also found that one in five Americans on prescription medications say that they find it difficult to pay for their drugs, and that nearly three quarters of Americans know little or nothing about a pending Supreme Court ruling on Obamacare. (Garver, 6/16)
Politico:
Lifesavers, Budget Breakers: Tackling Prescription Drug Costs
Drug spending shot up by 13 percent to hit $374 billion in 2014, as the breakthrough hepatitis C cure Sovaldi — at $84,000 for a 12-week treatment — put the spotlight on the eye-popping costs of some new drugs. Facing a pipeline full of pricey new cholesterol, cancer and anti-inflammatory drugs, a national conversation is swirling around what, if anything, can or should be done to restrain prices. (6/16)
The Philadelphia Inquirer:
Penn's Emanuel On High-Priced Drugs, High-Priced Technology, Including Penn's
Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania, is not afraid of delivering difficult news. Speaking to biotech and health executives at an invitation-only event Monday in Philadelphia, he said he was invited as a counter balance to other speakers, whom he described as "techno utopians," people who are gung-ho on medical technology and are less vocal on the costs to the entire health care system. (Sell, 6/16)
Meanwhile, an expected rule proposal could impose a $5,000 fine on drugmakers each time they are found to have overcharged hospitals under the federal 340B drug discount program -
CQ Healthbeat:
Drugmakers May Face $5,000 Fines For Breaking 340B Program Rules
Pharmaceutical companies could face a fine of as much as $5,000 each time that they are found to have overcharged hospitals and other participants in a federal drug discount program under a rule expected to be proposed in the Federal Register on Wednesday. The proposed rule regards prices and penalties for the 340B program. The Office of Management and Budget is continuing to review a broader guidance document regarding the the program, named for the section of federal public health law under which it was created in 1992. There have been strong calls for greater clarity from both drugmakers that lose revenue through the 340B program and the hospitals and other organizations that benefit from its discounts. With about $7 billion in purchases made through the program annually, it represents about 2 percent of the nation’s total prescription drug market, according to the Health Resources and Services Administration, which oversees the 340B program. “We want to make sure that federal officials can efficiently and responsibly exercise their power to impose monetary penalties against drug companies that charge above statutorily defined 340B ceiling prices,” said Randy Barrett, a spokesman for 340B Health, a group that represents hospitals enrolled in the program. “Today's proposed rule is a welcome first step in putting a process in place to guarantee that safety-net providers receive the lower prices to which they are legally entitled.” (Young, 6/16)
Food Industry Must Phase Out Trans Fats Over Next Three Years
While partially hydrogenated oils were once promoted by doctors, the Food and Drug Administration now says the substances clog arteries and are unsafe. Use of artificial trans fats has dropped 78 percent over the last decade but they are still found in products like microwave popcorn, whipped topping and pie crusts. The Washington Post profiles the 100-year-old professor from the University of Illinois who led the charge to ban them.
Bloomberg News:
U.S. Bans Trans Fat In Boost For Palm Oil And Blow For Pie
Artificial trans fat will be removed from the U.S. food supply over the next three years under a ruling by regulators that the products pose health risks that contribute to heart disease. There's no longer a scientific consensus that partially hydrogenated oils, the main source of trans fat, are generally recognized as safe, according to a final decision released Tuesday by the Food and Drug Administration. The oils are used for frying and in baked goods as well as in confections. (Edney and Giammona, 6/16)
The Associated Press:
FDA Tells Food Industry To Phase Out Artificial Trans Fats
Popular foods like pie crusts, frostings and microwave popcorn will be largely rid of artery-clogging trans fats after a decision by the Obama administration to phase them out over the next three years. (Jalonick, 6/16)
The Washington Post:
The 100-Year-Old Scientist Who Pushed The FDA To Ban Artificial Trans Fat
No one was more pleased by the Food and Drug Administration's decision Tuesday to eliminate artificial trans fats from the U.S. food supply than Fred Kummerow, a 100-year-old University of Illinois professor who has warned about the dangers of the artery-clogging substance for nearly six decades. (Dennis, 6/16)
The Washington Post:
Why Doctors Used To Love Trans Fats
There’s a bit in the Woody Allen movie “Sleeper” where the protagonist, suddenly revived after being cryogenically frozen for two centuries, requests a bowl of wheat germ and organic honey for breakfast. “Ah yes,” a white coat-clad doctor says, a hint of derision in his voice. “Those were the charmed substances that some years ago were thought to contain life preserving properties.” (Kaplan, 6/17)
Updated Birth Control Training For Counselors Cuts Unintended Pregnancies
Instead of directly educating women about IUDs and implants, researchers at the University of California, San Francisco, conducted a study to see if educating health care workers about the latest innovations regarding contraceptives would make a difference. It cut unintended pregnancies in half.
NPR:
Updated Training Of Birth Control Counselors Boosts Use Of IUDs
The most effective reversible birth control methods are hormonal implants and intrauterine devices. Less than 1 percent of women using these long-acting contraceptive methods will become pregnant over the course of a year. That's compared to 9 percent of women using the pill who will get pregnant, and to 18 percent of women whose partners use a condom. Researchers from the University of California, San Francisco had an interesting idea about how to increase that rate. Instead of directly educating women about IUDs and implants, they conducted a study to see if educating health care workers about the latest innovations and statistics regarding contraceptives would make a difference. It did. Unintended pregnancy rates among young women in the study dropped by almost half. (Aliferis, 6/16)
Reuters:
Training Clinic Staff About Birth Control Options Reduces Pregnancies
Training staffers at reproductive health clinics to educate women about birth control options ultimately cut pregnancy rates in half, according to a new study. For the new study, the researchers randomly assigned 40 Planned Parenthood reproductive health clinics to receive training or continue normal care without the added training from 2011 to 2013. (Seaman, 6/16)
Meanwhile, some congressional Republicans want to increase access to over-the-counter birth control -
Politico:
'War On Women': The GOP Counteroffensive
Republicans believe they’ve found one way to begin to blunt incessant attacks that they’re anti-women: increase access to over-the-counter birth control. Democrats call the proposal by several GOP senators a political ploy by a party that’s more interested in fighting reproductive rights and Obamacare. (Kim and Haberkorn, 6/17)
California Breaks Ground In Offering Health Coverage To Children In U.S. Illegally
Immigrant children would receive public health care coverage in California under a budget deal announced Tuesday by Gov. Jerry Brown and legislative leaders.
The Associated Press:
California Budget To Break New Ground For Immigrant Health Care
A budget deal between Gov. Jerry Brown and legislative leaders would make California the first in the nation to offer state-subsidized health care to children who are in the country illegally. The $115.4 billion agreement announced Tuesday is expected to win easy approval from the Senate and Assembly before the fiscal year begins July 1, and its immigrant health care provisions were touted by its backers as a necessity in the face of federal inaction. (Lin, 6/16)
Los Angeles Times:
California Budget Deal Grants Health Coverage To Children In U.S. Illegally
Immigrant children who are in the country illegally would receive public healthcare coverage in California under a budget deal announced Tuesday by Gov. Jerry Brown and legislative leaders. An estimated 170,000 immigrants 18 and younger could qualify, marking another victory for advocates and lawmakers who have worked to make the state more welcoming to unauthorized residents. (Megerian and Mason, 6/16)
California Healthline:
Budget Passage Not the Final Word
Health care advocates have not slowed their lobbying in Sacramento, even after the Legislature passed an on-time balanced budget on Monday. On Wednesday, for instance, a 24-hour protest is planned outside the Capitol Building. Advocates who want to support the child care effort in California have announced they will hold an all-day, all-night vigil on the Capitol steps to push the governor to sign the budget as it stands. The governor has stated opposition to a number of health care provisions passed in Monday's budget, including full-scope Medi-Cal coverage of the state's undocumented children. (Gorn, 6/16)
And in Florida, a budget deal is reached that does not include Medicaid expansion -
Orlando Sentinel:
Lawmakers Finally Cut Deal On State Budget
Leaders of the Florida Legislature agreed to a nearly $80 billion state budget loaded with new projects late Monday, clearing the way for lawmakers to end months of squabbling and adjourn their special session Friday.
... (Senate President Andy) Gardiner wanted to expand health care using Medicaid funding, a proposal that House leaders vehemently opposed and ultimately killed. At the same time, lawmakers were forced to deal with how to pay for a different Medicaid program called the Low Income Pool, a $2.2 billion fund that originally had been set to expire on June 30. Federal officials in May, however, gave tentative approval for $1 billion for LIP and a two-year extension to the program, which pays hospitals for health care services for the poor and uninsured. House and Senate leaders eventually agreed to use $400 million in state funding to bolster LIP. (Rohrer & Sweeney, 6/16)
California, Massachusetts Medicaid Programs Blasted
In California, a state auditor says that more than 9 million Medi-Cal enrollees in managed care plans may not have adequate access to doctors, while in Massachusetts, the program for low-income residents misspent $500 million, according to a state audit.
Los Angeles Times:
Medi-Cal Patients May Not Have Adequate Access To Doctors, Audit Finds
Since signing up for Medi-Cal more than a year ago, Kevin Hill hasn’t been able to find a doctor. He said he called at least 15 physicians near his home in Long Beach who were listed in his health plan’s provider directory. But either the phone numbers didn’t work or the doctors weren’t accepting new patients, he said. He's given up. “Now I just go to an emergency center to pay cash even though I can barely afford it,” the 58-year-old said. (Karlamangla, 6/16)
The San Jose Mercury News:
California State Auditor Blasts Medi-Cal Program For Inadequate Provider Networks
A scathing state review of California's strained Medi-Cal program confirms what thousands of the health plan's exasperated enrollees have long complained about: The department tasked with overseeing health care for almost one third of the state's residents cannot ensure it has enough doctors to serve its 12.3 million patients. (Seipel, 6/16)
The Sacramento Bee:
Audit: California’s Medi-Cal Phone Lines Overwhelmed
Thousands of calls to California’s Medi-Cal complaint lines don’t get through, and thousands more that manage to ring the call center go unanswered, according to a new state audit. For the year that ended in January 2015, the phone system to the Medi-Cal ombudsman’s office rejected up to 45,000 calls in a month, State Auditor Elaine Howle said in her report to lawmakers. (Ortiz, 6/16)
Kaiser Health News:
State Auditor Slams California’s Oversight Of Medi-Cal Plans Used By 9 Million
California health officials failed to ensure that more than 9 million residents enrolled in Medi-Cal managed care plans had access to doctors when they needed them, the state auditor said in a stinging report Tuesday. Health officials might have learned about those problems from calls to an ombudsman’s office – but thousands went unanswered every month. (Feder Ostrov, 6/16)
Meanwhile, Massachusetts' Medicaid program is also under the microscope -
The Boston Globe:
MassHealth Overspent $500M, Audit Finds
The state’s Medicaid program spent more than $500 million over five years on improper or unnecessary payments, according to a state audit released Tuesday. State Auditor Suzanne M. Bump asserts that the state paid for services that should have been covered by the health insurers it contracts with to manage care. (Freyer, 6/16)
The Associated Press:
Audit: Medicaid Program Squandered More Than $500M
The state Medicaid program squandered more than $500 million through unnecessary payments or missed savings opportunities in its managed care program, according to an audit released Tuesday. The review by State Auditor Suzanne Bump found MassHealth, the state Medicaid program, made $233 million in unnecessary payments for medical services that should have been covered by managed care organizations between October 2009 and September 2014. The audit also says the state could have saved $288 million more through more detailed structuring of managed care contracts. (LeBlanc, 6/16)
'Unacceptable' Numbers Of Pa. Foster Children Take Psychiatric Drugs, Report Says
A study found that 43 percent of 6- to 18-year-olds in Pennsylvania's foster care system were given such drugs in 2012. Those children were almost three times more likely than other children on Medicaid to take psychotropic medications, which are typically prescribed to manage mental health or behavioral symptoms. And they were four times more likely to be on anti-psychotics.
The Associated Press:
Study: Pa. Foster Children Given Certain Drugs At High Rate
Pennsylvania foster children take psychotropic medications and antipsychotics at a far higher rate than other youth in the state, a study released Tuesday found. School-aged children in foster care use psychotropic drugs meant to treat mental and behavior disorders at nearly three times the overall rate for youth in the state's Medicaid system, according to a study by the state Department of Human Services and the Children's Hospital of Philadelphia. (6/16)
The Philadelphia Inquirer:
Report: Too Many Pa. Foster Kids Take Antipsychotic Meds
Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania, is not afraid of delivering difficult news. Speaking to biotech and health executives at an invitation-only event Monday in Philadelphia, he said he was invited as a counter balance to other speakers, whom he described as "techno utopians," people who are gung-ho on medical technology and are less vocal on the costs to the entire health care system. (Burling, 6/17)
News outlets report on health care developments in New Jersey, Massachusetts, Arizona, Montana, California, Florida, Michigan, Ohio, and Virginia.
The Philadelphia Inquirer:
N.J. Bills Would Give Cooper Control Of Camden's Paramedic Services
South Jersey Democrats are fast-tracking a bill that would give Cooper University Hospital control over paramedic services in Camden, currently run by a rival hospital, in a move that critics say circumvents state regulations. Committees in the Assembly and Senate on Monday each advanced the legislation, sponsored by two Camden County Democrats, Assemblyman Gilbert "Whip" Wilson and Sen. Nilsa Cruz-Perez. (Seidman, 6/16)
NJ Spotlight:
Cooper Scores First-Round Victory On EMS Legislation, But Key Senator Slams Plan
A paramedic-coverage bill sought by Cooper University Health Care advanced in Trenton yesterday, but not before the chairman of the Senate Health, Human Services, and Senior Citizens Committee questioned its impact and described it as a dangerous approach to health policy. The bill, S-2980/A-4526, would give Cooper the authority to operate Camden’s paramedic services, taking them away from rival Virtua Health. Committees in both the state Assembly and state Senate released the legislation, but Sen. Joseph F. Vitale (D-Middlesex) said was “not a good bill.” (Kitchenman, 6/16)
The Boston Globe:
Home Care Workers Say Company Thwarting Union Efforts
A group of Boston home care workers say their company is trying to thwart their attempts to unionize, forcing them to cancel appointments with elderly clients to attend anti-union meetings, even promising $1,000 bonuses for some if they keep workers from organizing. ... Following an organizing campaign by the local health care workers union 1199 SEIU, Boston caregivers are holding a mail-in union vote this week overseen by the National Labor Relations Board. (Johnston, 6/17)
The Associated Press:
Arizona Doctors Won't Have To Say Abortions Can Be Reversed
Arizona's attorney general won't enforce a disputed section of a new law requiring abortion providers to tell women they can reverse drug-induced abortions until the matter can be sorted in court. The decision made public Tuesday comes as the state prepares to defend itself in a lawsuit filed by abortion providers. Critics have said there's no science that shows drug-induced abortions can be reversed, and abortion providers argue it's unconstitutional to require doctors to say something that goes against their medical judgment. (6/16)
The Associated Press:
State To Create New Office Of American Indian Health
Gov. Steve Bullock signed an executive order Tuesday to establish a state Office of American Indian Health, saying the current health care system in Indian Country limits access to preventative care and quality health care services and providers. He said the new office will address vast health disparities between American Indians and non-Indians in the state. A study done by the Department of Health and Human Services in 2013 shows that the average life expectancy for American Indians in Montana is 20 years shorter than for non-Indians. (Baumann, 6/16)
The Sacramento Bee:
Sacramento County Approves Health Care For Undocumented Immigrants
Sacramento County supervisors on Tuesday approved health care for undocumented immigrants and other new social service programs as part of the county budget for the fiscal year starting July 1. ... Board chair Phil Serna called the budget historic, a term advocates and other county officials used to describe the county’s investment in new programs. Sacramento was one of a handful of counties in the state that once provided health care to undocumented immigrants, all of which stopped during the recession, Serna said. Sacramento County appears to be the first in California to restore its health care for undocumented immigrants. (Branan, 6/16)
The Associated Press:
Miami Home Health Company To Pay $17M In Medicare Scam
A Miami home health company has agreed to pay $17 million for allegedly paying doctors to refer Medicare patients. Department of Justice officials said Tuesday that the settlement with Hebrew Homes Health Network Inc. is the largest involving alleged violations of the Anti-Kickback Statute by skilled nursing facilities in the United States. (6/16)
The Detroit Free Press:
Is Your Boss Passing Health Care Costs On To You?
The rise in health care costs is beginning to slow for some southeast Michigan businesses. But not because health care is getting less expensive. A new employer survey shows that businesses and government employers are dealing with the growing expense of employee health care by passing more of the costs on to workers and introducing high-deductible insurance plans. (Reindl, 6/16)
Cincinnati Enquirer:
New St. E Clinic To Treat Heroin Addicts With Meds
Northern Kentucky residents addicted to heroin will have a new avenue for help in about a month when St. Elizabeth Physicians opens a clinic offering intervention with medicine.
The clinic, at 230 Thomas More Parkway in Crestview Hills, will be a pilot program for medication-assisted treatment for heroin addiction, to start. Gradually, it will encompass treatment of all opiate addiction and eventually, all substance-use disorder, said St. Elizabeth spokesman Guy Karrick. (DeMio, 6/16)
The Detroit Free Press:
Murder-Suicide Underlines Strain Of Autism Care
The murder-suicide of a Melvindale father and his adult autistic son is unsettling but not exactly surprising, according to one expert, who says Michigan is facing an ongoing crisis in handling the vast number of people affected by the disorder. As autistic children age, it becomes increasingly difficult for many parents to handle their symptoms and behavior, said Colleen Allen, president and CEO of the Autism Alliance of Michigan. (Stafford, 6/16)
The Richmond Times Dispatch:
C3 Nexus To Launch Study With Mayo Clinic
Richmond-based C3 Nexus will test its strategy to prevent hospital readmission in a study with the Mayo Clinic and the National Institutes of Health. C3 uses a heart monitor that tracks the blood pressure, heart beat and rhythm of heart failure and heart attack patients after they are discharged from the hospital. Nurses monitor the data, call and visit patients and try to catch potential problems before a patient winds up back in the hospital. (Geiger, 6/16)
The New York Times:
John Kasich, Ohio’s Republican Rebel, Nears Run For President
The rebel tag is apt, but it may go only so far with conservatives. Mr. Kasich has expanded Medicaid under President Obama’s health care law, embraced the Common Core educational standards and said he was open to a pathway to citizenship for illegal immigrants — policies that he might have a hard time explaining to conservatives in Iowa. (Stolberg, 6/16)
Viewpoints: How Obamacare Could Put The GOP In A Pickle; Is That Doughnut Becoming Less Deadly?
A selection of opinions on health care from around the country.
The Washington Post's The Fix:
The GOP’s Looming Pickle On Obamacare
If there's one thing that Social Security and Medicare have shown us, it's that once a big government program that provides assistance to many Americans is in place, you'll have a devil of the time rolling it back. Polling these days shows basically any reform that involves cutting benefits in these entitlement programs is an overwhelming political loser. (Aaron Blake, 6/16)
New Republic:
A Victory For Obamacare's Challengers Will Be A Disaster For Republican Candidates
Once the conservative legal strategy that gave rise to King v. Burwell got off the ground, Republicans in Congress probably had no choice but to become cheerleaders for, or active participants in, the ensuing litigation. The imminence of the decision in the Obamacare challenge, expected from the Supreme Court sometime this month, is exposing the terrible predicament the entire strategy created for the party. (Brian Beutler, 6/17)
New Hampshire Union Leader:
Betsy McCaughey: Don't Believe The King v. Burwell Hysteria
Health insurers have announced they will hike premiums on Obamacare plans by double digits in 2016. That’s not a problem for consumers eligible for Obamacare’s taxpayer-funded subsidies. Their cost is calculated based on their income. It’s you — the taxpayers — who get gouged when premiums are hiked, because you foot the bill for the subsidies. That makes the Supreme Court ruling in King v. Burwell, expected some day this month, even more consequential. It will determine the fate of these subsidies. Without them, Obamacare buyers in 37 states will have to pay the actual — and unaffordable — sticker price of Obamacare. And taxpayers will be off the hook for hundreds of billions of dollars over the next decade. (Betsy McCaughey, 6/16)
Bloomberg View:
Your Doughnut Is No Longer Out To Kill You
Over the past decade, Americans have cut their consumption of "partially hydrogenated" solid fats -- also known as trans fats -- by 85 percent, thanks to government-mandated labeling, consumers' preference for more healthful products and changes by food producers. But the 15 percent that remains is far too much. That's why the U.S. Food and Drug Administration is right to make good on its promise to ban added trans fats entirely. It's a move that could save thousands of lives. (6/16)
The Wall Street Journal:
Is The FDA Sexist?
Hillary Clinton isn’t the only one hoping to break a glass ceiling. Eighteen years after the Food and Drug Administration approved the first treatment for male sexual dysfunction, the FDA is poised to do the same soon for a drug sometimes called “Viagra for women.” If only this milestone for gender equality didn’t seem so, well, political. Flibanserin is a new medicine to treat a lack of sexual desire in premenopausal women. Hypoactive sexual desire disorder may effect as many as one of 10 women, who are eight to 10 times more likely than their peers to report feeling unhappy, frustrated or ashamed, and it can undermine relationships, confidence and self-image. (6/16)
The Detroit Free Press:
Nation Must Help Those With Serious Mental Illness
U.S. Sen. Debbie Stabenow has been a champion for mental health care throughout her career. Her efforts paid off for the 1 in 4 Americans impacted by a serious mental illness with the passage of the Excellence in Mental Health Act. The senator’s efforts are personal and professional. Her father struggled with bipolar disorder and went undiagnosed for nearly a decade when she was growing up; that drove her passion to seek change. Her father didn’t get the treatment he needed for years, and it affected her entire family. (Watkins, 6/14)
The Washington Post:
D.C.’s Slow Reaction To Synthetic Drugs
What has taken so long? Bewailing the problem of dangerous synthetic drugs, used primarily by young people in the District, Mayor Muriel E. Bowser (D) announced this week — and with much fanfare — a plan to shut down businesses peddling that stuff. (Colbert I. King, 6/16)