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Political Cartoon: 'Hypocritic Oath?'

Kaiser Health News - Fri, 09/12/2014 - 9:20am

Kaiser Health News provides a fresh take on health policy developments with "Hypocritic Oath?" by Darrin Bell.

And here's today's health policy haiku:

BIRTH CONTROL PILLS, COST-SHARING AND RETAIL CONFUSION

Copays don't apply
to the pill. Except they might
if you don't watch out.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Categories: Health Care

American Bar Association Magna Carta Traveling Exhibition – Pic of the Week

In Custodia Legis - Fri, 09/12/2014 - 9:02am

The American Bar Association traveling exhibition, Magna Carta: Enduring Legacy 1215-2015, debuted at their annual meeting in Boston on August 8, 2014. [Photo by David S. Mao]

On August 8, the American Bar Association debuted the traveling exhibition, Magna Carta: Enduring Legacy 1215-2015, at their annual meeting in Boston.  Nathan Dorn gave a “pop-up speech” at the conference’s expo to discuss how the narrative and images came together to tell the story of 800 years of Magna Carta.  Law Librarian of Congress David S. Mao greeted visitors to the traveling exhibition and discussed the Law Library’s collections.

The first few banners present historical context for the creation of Magna Carta in England while the next few banners present the impact of Magna Carta’s principles on the fledgling colonies of the United States.  The last half of the exhibition is dedicated to the individual liberties – such as due process of law, trial by jury, and the writ of habeas corpus – that found a permanent home in the American founding documents.

Check out the dates and locations to see if the traveling exhibit is coming to a venue near you!

Categories: Research & Litigation

First Edition: September 12, 2014

Kaiser Health News - Fri, 09/12/2014 - 7:13am

Today's headlines include reports about various health law political and policy developments.  

Kaiser Health News: Census Bureau: Health Costs Inch Up As Obamacare Kicks In
Kaiser Health News staff writer Jay Hancock reports: “Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show. But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago” (Hancock, 9/11). Read the story.

Kaiser Health News: Health Law Shows Little Effect In Lowering Children's Uninsured Rate, Study Finds
Kaiser Health News’ consumer columnist Michelle Andrews writes: “The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program” (Andrews, 9/12). Read the story.

Kaiser Health News: Capsules: Apparent Retail Glitch Triggers Copays For Birth Control
Now on Kaiser Health News’ blog, Shefali Luthra reports: “CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error remains currently unclear. The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay” (Luthra, 9/11). Check out what else is on the blog.

The Washington Post’s Wonkblog: Measuring The Impact Of States’ Obamacare Decisions
The early story of the Affordable Care Act can be challenging to generalize sometimes because so much of it depends on decisions made at the state level — both before and during implementation of the ACA. Did states defer to a federal-run exchange, or did they set up their own? In the states that built their own insurance marketplaces, did the Web site actually work? Did they expand Medicaid programs to low-income adults? Did they temporarily let people keep their old health plans? (Millman, 9/11).

The Wall Street Journal’s Real Time Economics: Obamacare Participants Worse Off, But Don’t Blame Washington — Blame States, Paper Says
The president’s health-care law has made participants in most states worse off, but the result may reflect decisions made in state capitals, not the broader policy, a new study from a Yale University economist found. The average enrollee in a health plan made available under the Affordable Care Act saw individual welfare decline in 35 states, according to the study Amanda Kowalski presented Thursday at the Brookings Institution in Washington. The report found the majority of those states either handed over at least part of the rollout to the federal government or were crippled by technology glitches (Morath, 9/11).

The Wall Street Journal: Health-Care Spending Picks Up
The sprawling U.S. health-care industry saw revenue rebound last quarter, a sign that stronger spending at hospitals and medical offices could help boost U.S. economic growth to its highest level in eight years. Total revenue at health-care and social-assistance firms rose 3% in the second quarter from the first three months of the year, the Commerce Department said Thursday in its Quarterly Services Survey. Hospital revenue rose 2.8% from the first quarter and revenue at physician offices jumped 4.1% (Leubsdorf, 9/11).

Politico: House Returns To Anti-Obamacare Votes
House Republicans on Thursday returned to the Obamacare well for another vote against the law, this time to allow consumers to stay on once-canceled plans until 2019. The House approved the bill, 247-167, with the support of all Republicans and 25 Democrats. It was the first vote on the health care law since April (Haberkorn, 9/11).

The Wall Street Journal’s Washington Wire: Portman: Four Things A GOP Senate Could Do Quickly
Another early item on a GOP Senate’s agenda is oft-debated legislation to repeal the 2010 health care law, Mr. Portman said, but he hoped that it would be followed by other measures to replace the law with other health measures. President Obama, in fundraising events for Democrats this year, has made a big plea for keeping the Senate in Democratic hands to keep a check on Republican obstructionism (Hook, 9/11).

NPR: Changing Tack, GOP Candidates Support Better Access To Birth Control
A string of Republican candidates for Senate are supporting an issue usually associated with Democrats: increased access to contraception (Liasson, 9/12).

NPR: A Doctor Who Performed Abortions In South Texas Makes His Case
In a Brownsville family clinic, a powerfully built, bald doctor treats a never-ending line of sick and injured patients. He has been practicing for nearly four decades, but family medicine is not his calling. He seems an unlikely doctor to perform abortions. The son of an Army officer, he grew up in a deeply religious family in rural Texas. His career path was shaped by an experience in medical school in the early '70s. A young woman whose uterus had been accidentally pierced by a backroom abortionist bled to death in front of him. After Roe v. Wade was decided, the young doctor devoted his career to helping poor and working-class women terminate their unwanted pregnancies in South Texas (Goodwyn, 9/11).

Los Angeles Times: Skid Row Sweep Finds Many Homeless With Medical, Psychiatric Needs
A joint city-county sweep of skid row last month to provide sanitation and social services identified more than 100 homeless people in need of immediate medical and mental health care, officials said Wednesday. Eighty homeless people received medical attention for scabies, wounds and other conditions during the August operation and 27 were referred to mental health services, City Councilman Jose Huizar said in a statement (Holland, 9/11).

The Associated Press: Ohio: Law Against Lies Is Nullified
The case began in the 2010 congressional race after Steve Driehaus, a congressman at the time, filed a complaint when the Susan B. Anthony List planned to post billboards claiming the Democrat’s support for President Obama’s health care overhaul equated with support for abortion, even though he opposed abortion. Judge Black had said earlier that the anti-abortion group did not have standing to sue, and an appeals court agreed. But the Supreme Court said the challenge should be considered (9/11).

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page. 

Categories: Health Care

Health Law Shows Little Effect In Lowering Children's Uninsured Rate, Study Finds

Kaiser Health News - Fri, 09/12/2014 - 5:04am

The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program.

The Urban Institute's health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods.

Part of the explanation is that even before the health law passed, the uninsured rate for children was already quite low, says Genevieve Kenney, a senior fellow at the Urban Institute and the lead author of the study. Rates had been declining for years, pushed lower by expansions in coverage for children under state Medicaid and CHIP.

In addition, the study doesn't reflect state variations. The rates for kids may well be declining in states that expanded Medicaid coverage to adults with incomes up to 138 percent of the federal poverty level (about $16,000 for an individual), as parents sign their kids up at the same time that they enroll in coverage themselves. But four states with large concentrations of uninsured children – Florida, Georgia, North Carolina and Texas – are not expanding their Medicaid programs.

More than 80 percent of the uninsured children in the survey are likely eligible for Medicaid or CHIP because their families have incomes at or below 250 percent of the poverty level ($49,475 for a family of three). The median income threshold for Medicaid/CHIP across all states is 255 percent of poverty, Kenney says.

More From This Series Insuring Your Health

Parents of uninsured children should keep in mind that they can sign their kids up for Medicaid/CHIP at any time through healthcare.gov. There’s no open enrollment period.

In addition, income thresholds for the program are higher than many people realize, says Kenney. In 19 states, children in families with incomes over 300 percent of the federal poverty level could qualify for Medicaid or CHIP ($59,370 for a family of three), according to the study.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

Categories: Health Care

Census Bureau: Health Costs Inch Up As Obamacare Kicks In

Kaiser Health News - Thu, 09/11/2014 - 4:00pm

Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show.

But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago.

Thursday's results from the Census Bureau's survey of service industries join other recent cost indicators that "are quite a bit lower than what the folks at CMS were projecting," said Charles Roehrig, director of the Center for Sustainable Health Spending at the Altarum Institute, a nonprofit research and consulting outfit. "And they're lower than what we were expecting as well."

CMS is the Centers for Medicare & Medicaid Services, the government's main health care bookkeeper. Last week CMS projected that health-expenditure growth would accelerate to 5.6 percent this year from an estimated 3.6 percent in 2013.

But health and social spending as measured by the Census Bureau grew by only 3.7 percent from the second quarter of 2013 to the same quarter of 2014. Hospital revenue increased 4.9 percent during the same period. Revenue for physician offices barely budged, growing by only 0.6 percent. Medical lab revenue rose 1.9 percent.

The report is far from being the last word. It doesn't include spending on prescription drugs, which has been rising this year thanks to new  very expensive medicines for hepatitis C.

And while the Census Bureau’s year-over-year results for the second quarter show tame cost trends, the increase from the first quarter to the second was more substantial. Total health and social spending rose at an annual rate of more than 12 percent from first quarter to the next. If sustained, such acceleration would raise alarms and actuaries' blood pressure.

But some who follow costs closely don't think the pace will continue.

First, health spending suffered a mini-crash over the winter, as bad storms kept people away from caregivers. Hospitals and doctors billed less from January to March than they did last fall. Part of the second-quarter recovery may just have been catch-up, analysts said.

At the same time, many people covered through the health law's online marketplaces didn't sign up until close to the deadline at the end of March. Much of the spring increase may represent a one-time surge as those folks sought treatment for previously neglected conditions.

For those reasons, the year-over-year results for the second quarter may give a better indication of longer-term cost trends than the change from the first quarter to the second, Roehrig said.

Estimates vary, but no one disputes the idea that the Affordable Care Act's health insurance marketplaces and expansion of Medicaid for the poor have added millions of previously uninsured people to coverage rosters this year.

History and logic suggest that expanded coverage and an improving economy will boost long-term, national health expenditures from their average growth rate of 3.7 percent during the past five years. (That’s spending by everybody -- government programs, employer insurance, commercial plans and consumers paying out-of-pocket.)

But so far the speedup seems nowhere close to the near-double-digit rates in the early 2000s.

Larry Levitt, senior vice president for the Kaiser Family Foundation, called Thursday's Census data "murky and imperfect results that are consistent with the idea that health spending is starting to grow a bit more quickly." (Kaiser Health News is an editorially independent program of the Foundation.)

Categories: Health Care

Understanding Next Week's Census Figures on Poverty and Inequality

Center on Budget and Policy Priorities - Thu, 09/11/2014 - 3:43pm
On September 16, the Census Bureau will release official statistics on poverty and inequality in 2013.  Several points are worth noting in advance of the release. As in Other Recent Recoveries, Poverty Has Been Slow to Improve Over time, poverty rates tend to move roughly in tandem with economic indicators, which generally improved slightly in 2013.  The economy added 2 million jobs, the share of non-elderly adults with jobs edged up, and an index of total hours worked by all workers …
Categories: Benefits, Poverty

Understanding the Census Bureau's Upcoming Health Insurance Coverage Estimates

Center on Budget and Policy Priorities - Thu, 09/11/2014 - 3:40pm
The Census Bureau will release estimates on September 16 of the number and share of Americans without health coverage in 2013, based on its annual Current Population Survey (CPS).  While the CPS is the most widely used source of health coverage information, significant changes in its health coverage questions instituted for 2013 — the result of a multi-year Census initiative to improve the reliability and accuracy of the survey’s health coverage estimates — mean that the 2013 results …
Categories: Benefits, Poverty

Tackling Autism In Babies? Small Study An ‘Absolute Miracle,’ Says Mom

CommonHealth (WBUR) - Thu, 09/11/2014 - 11:29am

Megan says the experimental trial she participated in with her daughter Isabel was “an absolute miracle,” transforming the child from a troubled baby who looked headed for autism to a typical, happy preschooler.

Research out this week suggests that it’s never too early to begin therapy to treat some of the defining symptoms of autism. Karen Weintraub reports on the promising new findings in USA Today under the headline, “Study: Autism Signs In Babies Can Be Erased:”

In a small pilot study — the first to look at starting therapy in babies this young — researchers at the University of California Davis’ MIND Institute, began treating 7 babies who showed symptoms likely to turn into autism later. By their third birthdays, five of the children no longer exhibited any symptoms of autism, and a sixth was diagnosed with mild autism.

Because the study was so small, and autism cannot reliably be diagnosed in infancy, the researchers stopped short of calling the treatment a breakthrough. But they said they will be following up with a larger study, which they hoped would confirm the results.

One mother involved in the trial described the treatment as “an absolute miracle” for her daughter, Isabel. The mother, Megan, asked not to be fully identified, but talked openly about the trial and its benefits for her family.

At nine months old, Isabel wouldn’t turn her head when someone walked into a room calling her name. She never babbled, Megan said. She was physically delayed in fine and gross motor skills, and didn’t seem to know how to play with toys. All those are signs commonly seen in children who go on to be diagnosed with autism.

Megan heard about the trial through her pediatrician and the family – including Isabel’s dad and her older brother – moved from the Seattle area to Sacramento, so they could participate in the study.

In 12 weekly sessions, lead researcher Sally Rogers coached Megan and her husband John as they played with baby Isabel. Where most children will smile or giggle when happy, Isabel’s facial expressions didn’t change much; where others might cry if scared by a loud sound, Isabel rarely reacted to anything in her environment. But Rogers showed them that Isabel might glance over quickly when she was interested or look at her hands when something was too loud or overwhelming – cues that Megan and John could take to do more or less of whatever they were doing.

Once they learned to “speak” Isabel’s language, Megan said she and John were able to react to her and engage with their baby for the first time. Eventually, through this interaction, Isabel learned that she could communicate – and have fun doing it. That primed her to learn even more, Megan said.

Megan said she and her husband would never have figured out what to do without the coaching.

Isabel’s cues were too subtle, she said, and she and John needed to be taught the progressive steps so they could take Isabel through each one in turn.

“As she got farther along, there would be more spontaneous learning, but that’s because she had laid the groundwork,” Megan said.

Shortly after turning three in April, Isabel was assessed again, and was deemed to be a perfectly typical toddler. “She was at least average in every category,” her mother said. “In some areas, she was months and months ahead – even in some of her language skills. That was pretty mind-blowing.”

Even if Isabel hadn’t improved so much, the trial would have been worthwhile, Megan said, because it allowed her to feel like she was doing whatever she could to help her child.

Now, parenting Isabel has become much more fun, Megan said, and Isabel now adores and plays all sorts of games with her big brother.

“It’s just a rich time,” Megan said. “We’re discovering who she is and watching her personality blossom from being completely shut down. Just now we were at the park and she was a little dragon breathing fire.”

Categories: Health Care

Browse Law Library of Congress Content by Jurisdiction

In Custodia Legis - Thu, 09/11/2014 - 10:47am

We recently started to do some user testing on our website, Law.gov.  It has been interesting to listen to the feedback because I know the answers and sometimes people are close but miss what I can clearly see.  I’m sitting in my office occasionally saying things to the screen (while my phone is muted). I have sat in on user testing in the past with Jill MacNeice for Congress.gov and am really thankful that she can help us on the Law Library’s website now too.

One thing that I keep thinking about is how we have a lot of content in a variety of packages.  There is the Guide to Law Online, the Global Legal Monitor, Legal Topics, and In Custodia Legis to name a few.  We’ve spent some time updating our metadata so you can find our content easier via search, but we do not really have a good way to browse across all content from, for example, a jurisdiction.  One of our questions is to find something on adoption from Turkey, but users do not know if they should go to the Guide to Law Online or possibly the Global Legal Monitor.  They must know to go to the Legal Topics section.

As a way to test how useful this would be, I’m adding a partial sample jurisdiction browse list below.  When you select one, you will see results from across all of our content.  Let me know what you think in the comments.  Would it be useful to have a similar list broken down by topics?  Would you click on a browse list of topics or jurisdictions from our homepage?

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Categories: Research & Litigation

Employer Health Coverage Costs Show Modest Growth, But Worker Out-Of-Pocket Expenses Jump

Kaiser Health News - Thu, 09/11/2014 - 10:03am

The findings, based on a poll of employers conducted by the Kaiser Family Foundation and the Health Research & Educational Trust, also note that the availability of employer-sponsored health coverage was holding steady. (Kaiser Health News is an editorially independent program of the Foundation.)

The Wall Street Journal: Cost Of Employer Health Coverage Shows Muted Growth
The increase was slightly less than the 4 percent seen last year, according to the annual poll of employers performed by the nonprofit Kaiser Family Foundation along with the Health Research & Educational Trust, a nonprofit affiliated with the American Hospital Association. The share of the family-plan premium borne by employees was $4,823, or 29 percent of the total, the same percentage as last year. The total annual cost of employer coverage for an individual was $6,025 in the 2014 survey, up 2 percent, a difference that wasn't statistically significant (Mathews, 9/10). 

Los Angeles Times: Employer Health Rates Rise 3%, Worker Deductibles Top $1,200
Those results reflect a recent trend of slower growth in health care costs. But many employers and health-policy experts predict bigger increases for 2015 and beyond as the economy recovers (Terhune, 9/10). 

Politico: Workplace Insurance Coverage Levels Steady In Year One Of Obamacare
It’s only year one of the Obamacare exchanges, and the findings won’t quell the debate about how businesses will respond in the coming years to new requirements and more regulatory and economic changes to the health industry. But the steady availability of employer-sponsored coverage and the “extraordinarily modest” premium rise indicate that predictions that “the sky would fall” under Obamacare have not come to pass, said Drew Altman, president of the nonpartisan Kaiser Family Foundation, which conducted the study with the Health Research and Education Trust (Norman, 9/10).

Kaiser Health News: Family Insurance Premiums Rise Modestly For 3rd Year, Survey Finds
While both critics and supporters of the Affordable Care Act are likely to find fodder for their positions, the report portrays 2014 as a relatively stable year for employer coverage, with little change in the type of plans offered or their costs. The percentage of firms offering health benefits (55 percent) and the percentage of workers covered at those firms (62 percent) were statistically unchanged from 2013, despite predictions of the law’s critics that many firms would drop coverage (Appleby, 9/10).

USA Today: Employer Health Plan Deductibles See Big 5-Year Jump
A report out today puts numbers behind what hit many workers when they signed up for health insurance during open enrollment last year: deductible shock. Premiums for employer-paid insurance are up 3 percent this year, but deductibles are up nearly 50 percent since 2009, the report by the Kaiser Family Foundation shows (O’Donnell, 9/10). 

Reuters: U.S. Health Premiums Creep Up, But Out-Of-pocket Costs Jump
U.S. health insurance premiums are going up only 3 percent this year, to an average of $16,834 for a family. Workers will pay about 20 percent of that cost, or $4,823, according to a study released on Wednesday. The Kaiser Family Foundation's 2014 Employer Health Benefits report says that rate increases are slowing from recession highs that ran far above inflation rates. In the past 10 years, health care premiums rose a cumulative total of 69 percent. However, the big leap in deductibles offsets the good news for consumers (Pinsker, 9/10).

McClatchy: Job-Based Health Premiums Increasing Slowly, Deductibles Faster
Average premiums for job-based family health coverage are up just 3 percent this year, while the cost of single coverage rose only 2 percent, continuing a sustained trend of moderate growth in insurance costs, according to a nationwide survey of more than 2,000 businesses. The slowdown in premium growth is good news for the estimated 150 million Americans with employer-sponsored health coverage (Pugh, 9/10).

NBC News: Average Health Insurance Premiums Rise Slightly
Insurance companies raised their rates for premiums by about 3 percent this year for people covered by employer health insurance, which includes most Americans, according to a new report. The average family premium is $16,834, and the average employee pays $4,823 of that. “Premiums increased more slowly over the past five years than the preceding five years (26 percent vs. 34 percent) and well below the annual double-digit increases recorded in the late 1990s and early 2000s,” the Kaiser Family Foundation, which conducted the survey, said in a statement. Eighty percent of all covered workers must pay an average deductible of $1,217 (Fox, 9/10).

Atlanta Journal-Constitution: Employer Health Insurance Up Moderately This Year, Survey Finds
The average annual cost of employer-sponsored health insurance for a family rose three percent this year to $16,834, the Kaiser Family Foundation reported in its 2014 survey of employer health benefits released Wednesday. Of that, employees pay on average $4,823 a year towards the cost (Markiewicz, 9/10).

In related news -

Des Moines Register: Employers Stick With Health Insurance
Most Iowa employers continue to offer health insurance to their workers, even though costs keep rising and headaches keep multiplying, a new survey shows. Some critics of the federal Affordable Care Act predicted that many employers would drop insurance because the 2010 law included new regulations and costs. But that is not happening in a big way in Iowa, according to the annual survey of 1,002 employers that Lind is releasing today. In fact, the overall percentage of Iowa employers offering coverage ticked up from 77 percent in 2013 to 81 percent this year (Leys, 9/11).

Categories: Health Care

Officials Vow 'Improvement, But Not Perfection' For Healthcare.gov

Kaiser Health News - Thu, 09/11/2014 - 10:02am

Two months before the beginning of the next open enrollment period for government-subsidized health insurance, administration officials promised smoother operation of the website used by millions of people to sign up for coverage.

The Hill: IRS Chief: ‘Whenever We Can, We Follow The Law’
During another grueling hearing on the ObamaCare rollout, the head of the IRS tried to offer lawmakers an assurance about the soon-to-open enrollment period. “Whenever we can, we follow the law,” IRS Commissioner John Koskinen told the House Ways and Means subcommittee on health on Wednesday. Rep. Kevin Brady (R-Texas), who leads the subcommittee, immediately expressed his concern with the remarks. Lawmakers spent a majority of Wednesday's hearing grilling Koskinen and Andy Slavitt, HealthCare.gov's fix-it man, on how they would verify that consumers were providing correct income information as they signed up for insurance subsidies (Ferris, 9/10).

McClatchy: Republicans Grill Federal Officials Ahead Of 2nd Obamacare Enrollment Period
Two months before the second enrollment period begins to purchase health insurance through the online marketplaces set up by the Affordable Care Act, Congress is asking if it's going to go more smoothly this year. The federal website, HealthCare.gov, has been plagued with problems and technical glitches since its initial launch on Oct. 1. This summer, the site was successfully hacked for the first time, raising further questions about its security (Westerman, 9/10).

Kaiser Health News: Health On The Hill: HHS Official: Healthcare.gov Updates Will Be 'Improvement But Not Perfection'
Kaiser Health News staff writer Mary Agnes Carey and Politico Pro's Jennifer Haberkorn discuss testimony before a House subcommittee during which a key Obama administration official lays out the updates that HHS is making to the online marketplaces before enrollment begins in November (9/10).

Meanwhile, the Associated Press looks at the congressional to-do list -

The Associated Press: House, Senate Debate Measures Going Nowhere
On both ends of the Capitol, the parties controlling Congress are happily showcasing futility. Less than two months before pivotal congressional elections, Republicans were set Thursday to muscle legislation through the House that would let insurers continue selling health coverage that falls short of standards required by President Barack Obama’s health care law. The measure was sure to pass but then die in the Democratic-run Senate, and the White House promised an Obama veto in any event. Even so, the vote would let Republicans highlight their repeated efforts to debilitate the health care law. It will also dare Democrats to oppose an idea that appeals to some voters: letting them keep insurance they already have, an Obama promise that proved untrue for some consumers (9/10).

And a federal probe regarding health policy and insider trading continues -

The Wall Street Journal: Washington Trading Probe Broadens To Hedge Funds
Federal investigators have uncovered a flurry of communications between a Washington research firm and several hedge funds, opening a new front in an insider-trading probe focused on the firm's 2013 investor alert about a change in government health-care policy. The Wall Street Journal has previously reported that the Securities and Exchange Commission is investigating whether anyone in the government illegally leaked word of the announcement to Height Securities. Now, the agency is looking at whether hedge funds violated securities rules by trading on the resulting alert to Height Securities' clients (Mullins, Pulliam and Chung, 9/10). 

Categories: Health Care

Missouri Sets 72-Hour Wait For Women Seeking Abortions

Kaiser Health News - Thu, 09/11/2014 - 9:17am

The Republican-controlled legislature overrode Democratic Gov. Jay Nixon's veto to enact one of the most stringent waiting periods in the nation that includes no exception for cases of rape or incest.

The Associated Press: Missouri Enacts 72-Hour Abortion Waiting Period
Missouri women seeking abortions will face one of the nation's most stringent waiting periods, after state lawmakers overrode the governor's veto to enact a 72-hour delay that includes no exception for cases of rape or incest. The new requirement will take effect 30 days after Wednesday's vote by the Republican-led Legislature, overruling the veto of Democratic Gov. Jay Nixon. He had denounced the measure as "extreme and disrespectful" toward women (Lieb, 9/11).

Springfield (Mo.) News-Leader/USA Today: Mo. Overrides Veto Of 3-Day Abortion Waiting Period
Missouri lawmakers forced an extension of the state's abortion waiting period into law late Wednesday night after Republicans used a rare parliamentary tactic to kill a Democratic filibuster in the Senate. The House took the first step to forcing a 72-hour abortion waiting period into law early in the evening. The Senate began debating the measure soon after and passed it at about 11:30 p.m. Central Time (Shorman, 9/11).

Also in Missouri, a legislator challenges the health law's mandate that insurers cover birth control -

St. Louis Post-Dispatch: Missouri Lawmaker, Wife, Ask Court For Contraception Insurance Exclusion
A family should have the same right as a small business to opt out of birth control coverage in its health care plan, the lawyer for a Missouri legislator argued Monday before a federal appeals court. Rep. Paul Wieland, R-Imperial, and his wife, Teresa, say the contraceptive benefit required by the Affordable Care Act violates their religious beliefs as Catholics and parents of three daughters (Mann, 9/09).

MSNBC: Missouri Lawmaker Suing To Deny Daughters Birth Control Access
One Missouri lawmaker has taken the fight against birth control coverage to a new and very personal place: His own daughters, two of whom are adults. State Rep. Paul Joseph Wieland and his wife Teresa are suing the Obama administration over its minimum coverage requirements for health plans under the Affordable Care Act, which includes contraception. They say the government is forcing them to violate their religious beliefs because they have three daughters, ages 13, 18 and 19, who are on their parents’ plan and might get birth control at no additional cost (Carmon, 9/10).

And in Texas, a candidate's abortion disclosure gets attention -

Texas Tribune: Davis’ Abortion Draws Attention To New Restrictions
State Sen. Wendy Davis has grabbed headlines across the country for her dramatic and heart-rending disclosures, contained in a new memoir, about an abortion that came late in her 1997 pregnancy.  The discussion is shedding light on a provision in the restrictive abortion legislation she tried in vain to stop last year — the part that bans abortions after 20 weeks of pregnancy, including in many cases when there are fetal abnormalities. Leading abortion rights experts on both sides of the issue say a woman facing the same circumstance in Texas today — assuming it arose after the 20-week mark — probably would not be allowed to terminate her pregnancy (Root, 9/11).

Categories: Health Care

State Highlights: Iowa Calls Out Limited-Benefit Plans; Texas Gov. Candidate Proposes $175M For Health Care

Kaiser Health News - Thu, 09/11/2014 - 9:16am

A selection of health policy stories from Iowa, Texas, Illinois, North Carolina, California and Montana.

Des Moines Register: Quit Peddling Skimpy Health Insurance, Iowa Tells Firms
Out-of-state businesses have been trying to trick Iowans into thinking that limited-benefit insurance plans offer full-fledged health coverage, state regulators said Wednesday. The Iowa Insurance Division filed a formal complaint this week against four people and several related companies. The division said the companies have been running misleading radio and TV ads encouraging people to call a toll-free number right away to find out about health insurance (Leys, 9/10).

Texas Tribune: Texas Gubernatorial Candidate Unveils New Health Policy Proposal
Increased funding for preventive care and luring medical professionals to Texas are at the center of gubernatorial candidate Greg Abbott’s health care plan, unveiled at St. Joseph's Women's Medical Center here on Wednesday. The Republican attorney general, running to replace Gov. Rick Perry, released a proposal that includes a $50 million budget increase for women’s health programs, additional funding for medical school residency slots in Texas, loan forgiveness for aspiring doctors who practice in underserved areas and compensation for doctors who provide care via telephone. Abbott said the cost of the entire plan would be $175 million every two years, but said it could actually save more than it costs (Ayala and Walters, 9/10).

Dallas Morning News: Greg Abbott Touts $175M New Spending For Health Care
Greg Abbott proposed Wednesday that state lawmakers provide another $175 million in health care spending, with a large portion devoted to cancer screening and treatment for low income women. In a proposal unveiled in Houston at a women’s health center, Abbott suggested that $50 million should be added for additional women’s services, including treatment for postpartum depression. He also proposed forgiving education loans to mental health workers willing to help in under-served areas and providing free mental health screening to veterans and service personnel (Hoppe, 9/10).

Chicago Sun Times:  Illinois County Shifts $2M To Cover Shortfall On Employee Health Insurance
The Porter County Council agreed Wednesday to use $2 million in income tax revenue to help cover a shortfall for county employees’ health insurance. That will help bridge, but not close, the gap for insurance costs for the rest of the year, county officials said. County commissioners offered up the $2 million in economic development income tax funds last week but said the council would need to figure out how to come up with whatever else was needed. Adams said 30 employees are responsible for about 50 percent of the county’s health insurance claims so far this year (Lavalley, 9/10).

McClatchy: North Carolina DHHS Secretary Defends $6.8 Million No Bid Contract
The state Department of Health and Human Services hired a company in a no-bid contract to oversee Medicaid finances in an emergency, agency Secretary Aldona Wos said Tuesday. DHHS didn’t have enough people or personnel with skills to oversee financial operations in the $13 billion health insurance program for the poor, elderly and disabled, Wos told legislators as she defended hiring Alvarez & Marsal, a Washington, D.C.-area firm (9/10).

Sacramento Bee: Jerry Brown Signs Bill Requiring Employers To Give Paid Sick Leave
Gov. Jerry Brown signed legislation Wednesday entitling most California workers to three paid sick days a year, a sweeping measure that Democrats and labor advocates have been seeking for years. The legislation affects about 40 percent of California’s workforce, about 6.5 million people who currently are not paid if they stay home when sick (Siders, 9/10).

San Francisco Chronicle: Churches Combat Health Disparities In Minorities Through Outreach
This is the fourth year of a National Cancer Institute-funded five-year project by researchers from Kaiser Permanente and UC Berkeley's School of Public Health to study faith-based cancer screening outreach methods. The purpose is to find ways to reduce cancer screening disparities among racial and ethnic minorities. Research has shown that among all racial and ethnic groups in the United States, African Americans are more likely to develop colorectal cancer and the most likely to die from it. Colon cancer death rates are about 45 percent higher in black Americans than in whites (Colliver, 9/10).

The Associated Press: Montana Vets Question Federal Health Officials
The acting director of the Veterans Affairs Montana Health Care System said Wednesday he isn’t waiting for a follow-up inspection to a national audit to figure out ways to cut the long waiting period for initial doctors’ appointments. An investigation into patient access problems in the VA’s health care system nationwide flagged the Fort Harrison medical center and outpatient centers in Billings and Great Falls as three of the 110 facilities in need of further review. The audit found that Fort Harrison patients wait an average of 48 days for their first appointment with a primary doctor. VA Montana officials said they are trying to cut that period down to less than 30 days (Volz, 9/10).

Categories: Health Care

OTC Contraceptive Issue Stirs Political, Policy Discord

Kaiser Health News - Thu, 09/11/2014 - 9:15am

Some GOP candidates continue to embrace this concept, as do some medical organizations, but certain women's health advocates see it as a charged issue that could cause women to pay more for birth control and put their health at risk. 

The Wall Street Journal: New Discord Brews On Over-the-Counter Contraceptives
Some major medical groups support the idea of making contraceptive drugs available without a prescription -- a proposal raised in some political races -- despite objections from women's health advocates that it could make women pay more for birth control and carry health risks. The idea has been pushed by Republican Senate candidates in North Carolina, Colorado, Virginia and Minnesota, a move widely seen as an attempt to deflect Democratic criticism about GOP stances on women's health and birth control. Some women's health groups say the push isn't really about expanding access to birth control but instead an attempt to undermine a piece of the Affordable Care Act (Burton and Andrews, 9/10). 

The Wall Street Journal: The Short Answer: Why Some Republicans Back Over-The-Counter Contraceptives
The number of Republicans calling for oral contraceptives to be available over-the-counter is on the rise, with North Carolina Senate candidate Thom Tillis and Colorado Senate candidate Rep. Cory Gardner bringing it up recently (9/10). 

Categories: Health Care

Data Miners Know What's In Your Medicine Cabinet

Kaiser Health News - Thu, 09/11/2014 - 9:15am
Bloomberg: How Big Data Peers Inside Your Medicine Chest
In a year when former National Security Agency contractor Edward Snowden’s revelations about the collection of U.S. phone data have sparked privacy fears, data miners have been quietly using their tools to peek into America’s medicine cabinets. Tapping social media, health-related phone apps and medical websites, data aggregators are scooping up bits and pieces of tens of millions of Americans’ medical histories. Even a purchase at the pharmacy can land a shopper on a health list (Pettypiece and Robertson, 9/11).
Categories: Health Care

What Cancer Patients Want May Not Be Covered By Medicare

Kaiser Health News - Thu, 09/11/2014 - 9:13am

Patients and their caregivers want options such as home-based long term care and palliative care delivered alongside treatment -- options that Medicare may not define as "reasonable and necessary," according to a Duke University study.

Reuters: What Cancer Patients Want And What Medicare Covers May Differ
When asked what Medicare should cover for cancer patients in their last months of life, many patients and their caregivers choose benefits the federal insurance does not offer, like home-based long term care and concurrent palliative care, according to a new study based on interviews. Given an array of options, a limited budget and a chance to discuss the choices, patients and caregivers were not very likely to devote all coverage to curative cancer treatment, said lead author Donald H. Taylor Jr., of the Sanford School of Public Policy at Duke University in Durham, North Carolina (Doyle, 9/10).

Kaiser Health News: You're Being Observed In The Hospital? Patients With Private Insurance Better Off Than Seniors
An increasing number of seniors who spend time in the hospital are surprised to learn that they were not "admitted" patients -- even though they may have stayed overnight in a hospital bed and received treatment, diagnostic tests and drugs. Because they were not considered sick enough to require admission but also were not healthy enough to go home, they were kept for observation care, a type of outpatient service. The distinction between inpatient status and outpatient status matters: Seniors must have three consecutive days as admitted patients to qualify for Medicare coverage for follow-up nursing home care .... But most observation patients with private health insurance don't face such tough choices. Private insurance policies generally pay for nursing home coverage whether a patient had been admitted or not (Jaffe, 9/11).

Categories: Health Care

Viewpoints: Conservative Alternative To Health Law Critiqued; Rare Slowdown In Premium Costs

Kaiser Health News - Thu, 09/11/2014 - 9:12am

Los Angeles Times: What's Wrong With The New Conservative Answer To Obamacare
The best sign that conservatives have finally given up their childish campaign to repeal the Affordable Care Act is that they've been cooking up proposals to keep some of the ACA's most important provisions in place, without fully abandoning Republican nostrums like tort reform. Most of these proposals are what social policy expert Harold Pollack aptly calls "vaporware" -- schemes designed to show that the GOP has something to offer, but that are essentially unworkable structurally or politically. But the most serious effort yet has now arrived from Avik Roy of Forbes and the conservative Manhattan Institute. Titled "Transcending Obamacare," Roy's plan has lately been receiving respectful attention from ACA experts and progressives (Michael Hiltzik, 9/10).

The New York Times: Stop The Anti-Obamacare Shenanigans
So far, opponents of the Affordable Care Act have lost every major battle to repeal or invalidate it. Some of them are now urging the courts to interpret the health reform law in a way that would guarantee its failure. This is a significant threat — potentially as grave as the previous main legal challenge to the law, which the Supreme Court rejected, 5 to 4, in 2012. If the new effort succeeds, it would create total chaos (Henry J. Aaron, David M. Cutler and Peter R. Orszag, 9/10).

USA Today: Medicaid Expansion Gets A Boost
[In Alabama] and in a handful of other red states, the pressure to expand Medicaid got a big boost last month. An ongoing study by Families USA concluded that workers make up many of those who could benefit from this provision of the Affordable Care Act. And working people make up more than half the potential beneficiaries in Alabama, Florida, Indiana, Missouri, North Carolina, Pennsylvania, Tennessee, Texas, Utah and Virginia (David Person, 9/10). 

WBUR: Surprise In Mass. Primary: 21 Percent For Single-Payer Candidate Berwick
Note to politicians: Backing "Medicare for all" is looking less and less like electoral poison. If, deep in your heart, you believe American health care would be better off with a Canadian-style, single-payer system, you might now consider coming out of the closet. (In Democratic primaries in blue states, at least.) That's my suggested takeaway from the striking Massachusetts Democratic primary showing of Dr. Donald Berwick, who rocketed from near-zero name recognition among general voters to 21 percent at the polls. Catch him saying forcefully in the video above: "Let’s take the step in health care that the rest of the country hasn't had the guts to take: single payer. Medicare for all" (Carey Goldberg, 9/10).

The New York Times' The Upshot: Latest Good News In Health Spending: Employer Premiums
We're in the midst of a rare slowdown in the growth of health spending. That slowdown just hit the employer health insurance market. On Wednesday, the Kaiser Family Foundation published its annual survey on the health plans that employers are offering their workers. It's large and comprehensive and generally regarded as the most reliable measure of what's happening in the employer market (Margot Sanger-Katz, 9/10). 

The Washington Post: Curb Your Enthusiasm About Those Medicare Savings
Contrary to some media reports, the Medicare monster hasn't been tamed. But it has been made a little less unruly. To be precise: Spending is regularly falling below projections, creating the prospect of hundreds of billions of savings over decades. ... True, the savings are significant. Still, they don't alter the nation’s central budget problem: Rising spending on the elderly is dictating government's priorities. It's squeezing other programs — from defense to medical research — while feeding big deficits and creating pressure for higher taxes (Robert J. Samuelson, 9/10). 

Bloomberg: Sell Birth Control Over-The-Counter
The Republican idea is to make birth-control pills available over-the-counter rather than a prescription item. This is an excellent idea. ... But it won’t have the effect that they seem to imagine. The administration can still require employer-sponsored insurance to cover over-the-counter medications that are prescribed by a doctor. And it probably will, because did I mention that the Base Wants It? Obviously, this keeps the conflict very much alive. It also diminishes much of the benefit of making the pills available over-the-counter (Megan McArdle, 9/10).

Categories: Health Care

Utah Lawmakers Eager To See Details Of Medicaid Expansion Deal Governor Is Negotiating

Kaiser Health News - Thu, 09/11/2014 - 9:12am

Gov. Gary Herbert is seeking to get a work requirement as part of the deal for expanding Medicaid to the state's low-income residents, but it's not yet clear what federal officials are willing to approve.

Deseret News: Work Requirement May Be Key To Selling Utah Lawmakers On Medicaid Expansion Alternative
Utah lawmakers want to see what kind of deal Gov. Gary Herbert finally makes with the Obama administration over a work requirement in his Healthy Utah alternative to Medicaid expansion. ... At least the concept of a work requirement in the governor's Healthy Utah plan got the nod Tuesday from U.S. Health and Human Services Secretary Sylvia Burwell during a meeting in Washington, D.C., with Herbert and other Utah officials. "In the past, they've always told us flat out 'no' on the work requirement," said Utah Department of Health Executive Director David Patton, who was in the meeting. "This was a real breakthrough" (Riley Roche, 9/10).

Also, North Dakota legislators are beginning to think about where they will find the money to fund their share of the Medicaid expansion.

Bismark Tribune: Lawmakers Discuss Medicaid Expansion Impact
[North Dakota Department of Human Services Executive Director Maggie] Anderson told lawmakers that additional state funding for Medicaid expansion will be a topic of discussion in the 2015 session due to a decrease in federal funding. States that expanded Medicaid were eligible for a 100 percent federal match for the first three years which will decline to 90 percent by 2020. In 2017 the federal match drops to 95 percent. Anderson said the remaining 5 percent "will need to be (state) general fund" dollars. She didn't have an estimate on how much this would cost for the final six months of the 2015-17 biennium (Smith, 9/10).

Categories: Health Care

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