KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

5 Challenges Facing Medicaid At 50

The federal-state health care program covers nearly half of all births, one-third of children across the country and two-thirds of people in nursing homes. (Phil Galewitz, 7/27)

Health Law Experiment Failed To Show Savings

An ambitious demonstration to transform clinics into “medical homes” treating patients in the community instead of the hospital didn’t save money. Some blame the test, not the idea. (Jay Hancock, 7/27)

Political Cartoon: 'Worried Sick?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Worried Sick?'" by Darrin Bell.

Here's today's health policy haiku:

SENATE'S FIRST REPEAL PUSH SINCE THE GOP TOOK OVER... TRY, TRY AGAIN!

Voting on Sunday?
But the health law repeal push
Still misses the mark.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Marketplace

Anthem-Cigna Deal Prompts Questions About Regulatory Scrutiny, Consumer Impact

News outlets detail various aspects of the billion-dollar agreement in which Anthem agrees to buy Cigna, including how this deal fits into the insurance sector's merger trend, what role the health law played in this market behavior, what might be in store regarding regulatory scrutiny and how the agreement may affect consumers.

The Wall Street Journal: Anthem Agrees To Buy Cigna For $48.4 Billion
The deal, combining the second- and fifth-largest health insurers by revenue, would create a company with a huge footprint in commercial insurance, the type of coverage provided to employers and consumers. ...The biggest companies are seeking more cost efficiency and scale as the health-care landscape changes because of the Affordable Care Act and other factors. Of the current major health insurers, only UnitedHealth Group Inc., the largest by revenue, has so far sat out the merger wave. (Wilde Mathews and Hoffman, 7/24)

The Associated Press: Why The 2010 Health Care Law Led To Insurance Merger Mania
The health care overhaul law has reshaped the health insurance business, and one consequence is more than $100 billion in mergers and acquisitions over the last few years. Anthem Inc.'s purchase of Cigna Corp. and Aetna Inc.'s acquisition of Humana Inc., both announced this month, are worth more than $80 billion combined. The companies snapped up competitors in smaller, but still hefty, deals for years before that. (6/24)

Bloomberg: Anthem-Cigna Deal Tied To Rival Mergers In Antitrust Review
The fate of Anthem Inc.’s proposed takeover of Cigna Corp. is now linked with that of Aetna Inc.’s bid for Humana Inc. as antitrust officials vow to scrutinize the industry as a whole amid the frenzy of dealmaking. The $48.4 billion purchase of Cigna announced Friday would cut the number of major health insurers to three from five, making it challenging for Anthem and its rivals to win approval from the Justice Department, antitrust experts say. (McLaughlin, 7/24)

Reuters: U.S. Health Insurer Mergers to Speed Industry Deals - Experts
Anthem Inc's decision to buy Cigna Corp, forming the largest U.S. health insurer by membership, will likely speed consolidation across the healthcare industry, from hospitals to drugmakers. Anthem announced its proposed $54 billion purchase of Cigna on Friday, just weeks after Aetna Inc said it would buy rival Humana Inc for $37 billion. If both transactions are approved by regulators, the industry will go from five major national players to three. (Beasley and Gumpert, 7/24)

Politico Pro: Antitrust Scrutiny Likely For Insurance Mergers
The last big domino has fallen in the wave of deals that has reshaped the health insurance industry in a few brief weeks. Anthem’s deal to purchase Cigna for $54 billion, announced Friday morning, will create the largest health insurance company in the country. The insurance behemoth will have $115 billion in revenues and 53 million members — 17 percent of the entire U.S. population. (Demko, 7/24)

USA Today: Are Insurer Deals Good For Consumers, Employers?
Health insurer Anthem's $54 billion deal to acquire Cigna could help keep health care costs from continuing to rise, as the insurers will have more negotiating leverage with doctors and hospitals, but the effect on employers remains unclear, say health care experts. (O'Donnell, 7/24)

Los Angeles Times: Q&A Will The Anthem-Cigna Deal Cost You Money?
Anthem Inc., California's largest for-profit health insurer, has agreed to acquire rival Cigna Corp. for $54 billion. The planned merger is the latest in a string of health insurance deals announced in the last few weeks. Aetna Inc. reached a $37-billion deal for Humana Inc. this month. And Woodland Hills insurer Health Net Inc. agreed to be acquired by Medicaid insurer Centene Corp. for $6.8 billion. (Masunaga and Terhune, 7/24)

The Connecticut Mirror: What Does The Anthem-Cigna Deal Mean For Consumers?
The announcement Friday that Anthem Inc. plans to buy Bloomfield-based Cigna Corp. comes amid a period of rapid consolidation in the health care industry that some observers have likened to an arms race. Hospitals – seeking, among other things, greater leverage in negotiating with insurers – have increasingly been joining larger systems, while the insurance industry – already concentrated in many states – is poised to undergo even more consolidation. Where does that leave consumers? (Levin Becker, 7/24)

Georgia Health News: Mega-Merger Would Bolster Blue Cross Here
Anthem’s agreement to buy Cigna for $48 billion, if consummated, would cement the dominant position of Georgia’s leading health insurer. The insurer deal, announced Friday, follows the merger agreement announced earlier this month between two other insurance heavyweights, Aetna and Humana. And both fit into the picture of fast-paced consolidation across the health care industry, partly driven by changes from the Affordable Care Act. (Miller, 7/24)

Federal Regulators OK First Of New, Costly Class Of Cholesterol-Lowering Drugs

The drug, Praluent, which is likely to become a huge seller, could be the next flashpoint regarding rising pharmaceutical prices. Health plans also are expected to put rules in place to control which patients can use it.

The New York Times: New Drug Sharply Lowers Cholesterol, But It’s Costly
Federal regulators on Friday approved the first of a new class of drug that can sharply lower cholesterol levels, offering a new option for millions of Americans suffering from cardiovascular disease, the nation’s leading killer. But the drug, Praluent, which analysts project will become a huge seller, is expected to become the next flashpoint in the growing controversy of escalating pharmaceutical prices, and health plans are expected to put in place strict measures to control which patients can use the drug and prevent it from becoming a budget buster. (Pollack, 7/24)

The Wall Street Journal: FDA Approves Cholesterol Drug From Regeneron, Sanofi
The drug, called Praluent and developed by Regeneron Pharmaceuticals Inc. and Sanofi SA, provides a new and in some cases desperately needed option for several million high-risk heart patients who can’t get their cholesterol to desirable levels with the blockbuster group of medicines known as statins. But the companies are pricing the drug at $14,600 a year, an especially high amount for a medicine aimed at a common condition like heart disease. By contrast, statins, which are available in generic versions and remain the mainstay drug option for cholesterol reduction, can be purchased for just a few dollars a month. (Winslow, 7/24)

The Hill: FDA Approves Cholesterol Drug With $15,000 Yearly Price Tag
A newly approved drug that has been hailed as a breakthrough treatment for high cholesterol is causing sticker stock across the healthcare industry. The injectable treatment, Praluent, is the first of a powerful new class of drugs proven to lower cholesterol. It also carries a list price of $14,600 a year — nearly twice what analysts had been expecting. While the newly approved drug is far from the most expensive on the market, it has potential for widespread use: It could be used by millions of people who have been unable to treat their high-cholesterol with existing — and cheaper — drugs. (Ferris, 7/24)

Reuters: New Heart Drugs Come In More Expensive Than Expected
Two of the most anticipated new heart drugs to be launched in recent years have been priced well above analyst expectations, fuelling the debate about whether modern medicines cost too much. Praluent, made by Sanofi and Regeneron Pharmaceuticals, and Entresto from Novartis are both treatments that represent significant advances for millions of patients at risk of serious heart problems. (Hirschler, 7/27)

Allergan's Exploration Of Company Split Could Mean Teva Acquires Generic Drug Unit

Allergan is reportedly contemplating splitting into two business -- keeping its brand-name business but spinning off its generic-drug unit. Teva is involved in talks to acquire it.

Reuters: Allergen Said To Be Exploring Split Into Two Businesses
Allergan Plc is considering a breakup of the company into two businesses, a person familiar with the matter told Reuters on Friday, potentially adding the botox-maker to a list of large drugmakers realigning themselves to focus on specific areas of their businesses. Allergan is considering keeping its branded drugs business but spinning off or selling parts or all of its generics business, according to the person who asked not to be identified because the deliberations are confidential. (Roumeliotis, 7/24)

The Wall Street Journal: Teva In Talks To Buy Allergan’s Generic-Drug Unit
Israeli drug maker Teva Pharmaceutical Industries Ltd. is in talks to combine with Allergan PLC’s big generic-drug business, in a move that would further consolidation in the health-care industry and likely mean the end of Teva’s pursuit of another acquisition. (Mattioli, Rockoff, Cimilluca and Hoffman, 7/26)

And Bloomberg offers this take on the health care sector -

Bloomberg: Drugs Trump Tech As Investors Shift Earnings Bets To Health Care
Traders are loading up on health-care shares, betting the industry will emerge as the brightest spot in an earnings period marked by disappointing results from some of the biggest technology companies. With the Affordable Care Act creating millions of more customers, health-care companies are forecast to see the strongest profit growth of any S&P 500 group in the second quarter. And with merger activity attracting investors seeking takeover premiums, the industry is the most secure and sustainable equity investment right now, according to Bruce Bittles of Robert W. Baird & Co. (Ciolli, 7/24)

Health Law Issues And Implementation

High Costs, Low Enrollment Set Up Steep Challenges For State Health Exchanges

The Associated Press reports that these issues may lead more states to turn over operations to the federal government. Meanwhile, news outlets in California and Iowa report on additional exchange developments, such as new insurers poised to participate in the Obamacare exchanges and rising 2016 premium rates.

The Associated Press: State Health Insurance Markets Struggle With Cost Challenges
State-run health insurance markets that offer coverage under President Barack Obama's health law are struggling with high costs and disappointing enrollment. These challenges could lead more of them to turn over operations to the federal government or join forces with other states. Hawaii's marketplace, the latest cautionary tale, was awarded $205 million in federal startup grants. It has spent about $139 million and enrolled 8,200 customers for individual coverage in 2015. Unable to sustain itself, the state marketplace is turning over sign-ups to the federal HealthCare.gov for 2016. (Alonso-Zaldivar, 7/26)

Los Angeles Times: Insurers UnitedHealth, Oscar Are Poised To Join Covered California
Two new health insurers are poised to join California's market for Obamacare coverage — industry giant UnitedHealth and a New York start-up named Oscar. Many consumers may welcome the new choices starting next year and the prospect that increased competition helps hold down premiums. The lack of more health plans to choose from has been a sore point for some Covered California customers during the rollout of the Affordable Care Act. (Terhune, 7/24)

The Associated Press: California Health Exchange To Announce 2016 Premium Rates
California on Monday will announce 2016 premium rates for individual health plans sold on the state's insurance exchange, an important gauge of affordability amid growing concern that some insurers around the country are seeking double-digit price increases. Last year, state officials declared victory when they announced premiums rose by an average of 4.2 percent, which was about half the increase the industry saw over a three-year period. But this year a number of health plans around the country have requested increases above 10 percent for 2016, saying their new customers turned out to be sicker than expected. (Lin, 7/27)

The Des Moines Register: Iowans Rip Plans To Raise Health Insurance Prices
Iowans who buy their own health insurance pleaded with the state's top regulator Saturday to reject big premium increases, but several expressed doubt their words would have much effect. Insurance Commissioner Nick Gerhart held a hearing on rate increases from Wellmark Blue Cross & Blue Shield and Coventry Health Care. Wellmark, the state's largest health insurance carrier, is proposing premium increases averaging 21 percent to 26 percent for 140,000 Iowans. Coventry, the largest Iowa carrier selling policies that qualify for Affordable Care Act subsidies, is proposing average increases of 17 percent for about 30,000 Iowans. (Leys, 7/25)

Also, the Star-Tribune connects dots among the health law, the rise of high-deductible health plans and increases in personal bankruptcy related to high medical costs -

The Minneapolis Star-Tribune: More In Minnesota Have Health Coverage But Still Can't Afford To Be Sick
The number of Minnesotans struggling to pay their medical bills is rising sharply, despite an increase in the number of residents who have health insurance. In the past year, Minnesota’s main hospital and clinic groups filed nearly 9,000 lawsuits against people with large or long-standing medical debts — a sharp increase since 2005, according to a Star Tribune analysis of court records. (Howatt, 7/26)

In other health law implementation news -

The St. Louis Post-Dispatch: Businesses Brace For The Next Big Health Fight: The 'Cadillac' Tax
Thought you had seen the end of major controversy over the Affordable Care Act? Think again. One of the last pieces to take effect promises to soon reignite the fierce debate on President Barack Obama’s landmark health overhaul. It’s known as the “Cadillac tax” — a hefty surcharge on relatively generous employer-sponsored health insurance. The tax won’t take effect until 2018, but many businesses are already bracing for it. (Shapiro, 7/25)

Kaiser Health News: Health Law Experiment Failed To Show Savings
Kaiser Health News staff writer Jay Hancock reports: "A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money, says a new government report. The test to coordinate treatment for high-risk Medicare patients in hundreds of communities was one of many demonstrations run by the Department of Health and Human Services’ innovation center." (Hancock, 7/27)

S.C. Democrats Pledge To Renew Medicaid Expansion Efforts Next Year

Meanwhile, in Kansas, Gov. Sam Brownback says his state's rural hospitals need innovation -- rather than the health law's Medicaid expansion -- to fend off their financial problems.

The Associated Press: Democrats To Renew Push For Medicaid Expansion In SC
Democrats plan to renew efforts next year to expand Medicaid eligibility in South Carolina, saying that's the most important way to continue the work of their slain colleague, Sen. Clementa Pinckney. It will be a tough sell in a state where Republican opposition hasn't budged since a 2012 U.S. Supreme Court ruling upheld the federal health care law but made its intended Medicaid expansion an option. But Democrats hope the Legislature's decision to remove the Confederate flag from Statehouse grounds — a move long thought impossible — indicates opinions can change. (Adcox, 7/25)

The Kansas Health Institute News Service: Brownback: Hospitals Need Innovation, Not Medicaid Expansion
Gov. Sam Brownback said Friday he’s unconvinced Medicaid expansion is an answer to the financial woes of rural Kansas hospitals and suggested they should innovate instead. During a news conference Friday, Brownback was asked about a Reuters story on the improving financial fortunes of public hospitals in states that expanded Medicaid under the federal Affordable Care Act versus the stagnation of hospitals in states that did not. The governor said he had seen another report recently that “went the other way.” (Marso, 7/24)

Capitol Hill Watch

In Sunday Vote, Senate Rejects Health Law Repeal

The effort fell 49-43, exactly along party lines. The mostly symbolic vote represented the chamber's first attempt to repeal the sweeping health care overhaul since the GOP took control in January.

Politico: Obamacare Repeal Vote Fails In Senate
The Senate on Sunday voted down a Republican effort to repeal Obamacare, the GOP’s first attempt to get rid of the president’s health law since the party took control of the chamber in January. The effort fell 49-43, exactly along party lines, with eight senators not voting in the rare weekend session. Third-fifths of the Senate would have had to vote to add Obamacare repeal to a highway funding bill. (Haberkorn, 7/26)

The Hill: Senate's Obamacare Repeal Effort Falls Short
The Senate on Sunday rejected a GOP-led amendment to repeal ObamaCare that fell several votes short of a 60-vote threshold to advance. The largely symbolic vote, which was attached to a three-year highway funding bill, marked the Senate’s first attempt to repeal ObamaCare since Republicans took control of the chamber in January. The measure had been certain to fail, lacking support from any Democrats. The final vote was 49-43 along party lines, with eight senators not voting. (Ferris, 7/26)

Also in news from the Senate -

McClatchy: Senate GOP Leaders Slam Cruz For Calling McConnell A Liar
The Senate’s Republican leadership rhetorically took Sen. Ted Cruz to the woodshed Sunday for calling Senate Majority Leader Mitch McConnell a liar last week on the chamber’s floor. Cruz was unbowed, firing back soon after leaving the Senate floor and accusing Senate Republican leaders of marching in lockstep with Senate Democrats on such things as funding the Affordable Care Act, funding Planned Parenthood and refusing to tie an Iran nuclear deal to Iran’s recognition of Israel’s right to exist. (Douglas, 7/26)

No Signs That Political Flap From Planned Parenthood Videos Is Quieting

If anything, the opposite is taking place. Some GOP lawmakers are pushing congressional efforts to defund the organization and Republican presidential candidates are using the recent developments in their fundraising. But few governors appear to be calling for investigations and, on the Sunday talk show circuit, Planned Parenthood's president took strong positions in defense of the group.

The Associated Press: No Sign That Issue Of Planned Parenthood Videos Is Fading
Two stealthily recorded videos show Planned Parenthood officials discussing how they provide aborted fetal organs for research. The videos have put the group and its Democratic allies on the defensive. It’s unclear how long the political damage may last or whether Planned Parenthood has broken federal law — as abortion foes contend. What is clear is that Republicans and anti-abortion groups are giving no signs of letting the issue fade quickly. (Fram, 7/27)

Reuters: Rand Paul Plans To Keep Pushing To Defund U.S. Planned Parenthood
U.S. Republican presidential contender Rand Paul said on Sunday he plans to push Congress to cut federal funding for the non-profit reproductive healthcare organization Planned Parenthood in a debate over its treatment of aborted fetal tissue. Senate Majority Leader Mitch McConnell has started a fast-track process to bring Paul's legislation for a vote soon, McConnell's spokesman told Reuters on Sunday. (Selyukh, 7/26)

Public Health And Education

Burwell Announces $133M In Funding For Substance Abuse Treatment

The announcement by Health and Human Services Secretary Sylvia Burwell came during the National Governors Association meeting. Meanwhile, a pair of Washington Post articles detail how long waiting lists and political dust-ups make it difficult for addicts to get help.

The Associated Press: Health Secretary Announces $133M In Substance Abuse Money
Department of Health & Human Services Secretary Sylvia Burwell has announced $133 million in additional money for substance abuse treatment. The announcement came Saturday at the National Governors Association summer meeting at The Greenbrier. A news release says the Health Resources and Services Administration is adding $100 million for more substance use disorder services, with a focus on addressing medication-assisted treatment for opioid use. (7/25)

The Washington Post: Long Waiting Lists For Drug Treatment Add To Addicts’ Desperation
Last month, Mercy, Maine’s largest treatment center, closed its doors and eliminated 250 beds because of declining insurance reimbursement rates. For addicts such as Cross, that leaves only the state-funded rehab program; the wait is 18 months. And a political battle over treatment funding threatens to add to addicts’ desperation in Maine: Last year, about 40 percent of heroin addicts who got treatment were put on methadone therapy. But Gov. Paul LePage (R) has proposed ending state funding for methadone treatment, saving about $1.6 million over two years. (Fisher, 7/26)

The Washington Post: Heroin's Resurgence: ‘And Then He Decided Not To Be’
It’s a place now ravaged by heroin — four overdoses, two of them fatal, in the past 10 months, in a town more accustomed to nothing of the kind. Maine is at the burning core of a nationwide heroin epidemic, the perverse outcome of a well-intentioned drive to save Americans from the last drug craze, a widespread hunger for heroin’s chemical cousin, prescription opiate pills such as Oxycontin. Heroin — now cheap, plentiful and more potent than ever — is killing people at record rates. (Fisher, 7/25)

State Watch

Likely Dismissal In Calif. Aid-In-Dying Lawsuit A Setback For Right-To-Die Advocates

San Diego Superior Court Judge Gregory Pollack said the issues were beyond his role as a judge to decide and that he will dismiss the case. A formal ruling is expected Monday. The plaintiffs say they will appeal.

NPR: California Judge Throws Out Lawsuit On Medically Assisted Suicide
Three terminally ill patients lost a court battle in California Friday over whether they should have the right to request and take lethal medication to hasten their deaths. San Diego Superior Court Judge Gregory Pollack said he would dismiss the case, adding that the issues were beyond his role as a judge to decide and should instead be put to the California state legislature or voters to establish new law. Plaintiffs vowed to appeal the ruling. (Dembosky, 7/24)

Kaiser Health News: California Judge Likely To Dismiss Aid-In-Dying Lawsuit
Christy O’Donnell may not get the death she had hoped for — one that right-to-die advocates say she deserves. A California judge on Friday indicated that he will likely dismiss her end-of-life lawsuit and said he would issue his decision Monday. "You’re asking this court to make new law,” San Diego Superior Court Judge Gregory Pollack said during a hearing Friday. "If new law is made it should be by the Legislature or by a ballot measure." (Ostrov, 7/27)

In related news -

The Boston Globe: New Guidelines May Encourage More Talks About End-Of-Life Care
Susan Johnson was never afraid to talk about death. But whenever she tried to discuss her end-of-life wishes with her children, both in their 40s, they deflected the topic with jokes. And her primary care doctor never raised the issue. Then, a few years ago, a surgical complication left Johnson hospitalized for months. She felt death close by, and it scared her. When she recovered and returned home to Salem, N.H., she invited her son and daughter for an Italian dinner, followed by a mandatory conversation — one with no jokes allowed. (Freyer, 7/27)

State Highlights: Two Major Health Care Players Fight It Out In South Fla.; Justice Dept. Says Va. Not Trying Hard Enough For People With Disabilities

Health care stories are reported from Florida, Virginia, Kansas, Illinois, California, Oregon, Minnesota, New Hampshire, New Jersey, Texas and Washington.

The Miami Herald: Hospital Giants Baptist, Mount Sinai In Miami Beach Slugfest
The site of a protracted slugfest between two South Florida healthcare heavyweights is one of the more nondescript patches of land in Miami Beach’s most famous neighborhood. A small, 45,000-square-foot parking lot east of Alton Road between Seventh and Eighth Streets may become a five-story building housing an urgent care center, medical offices, and outpatient surgery and physical therapy facility operated by the largest healthcare system in the region, Baptist Health. (Flechas, 7/25)

The Washington Post: Justice Department: Virginia Not Trying Hard Enough To Reform Programming For The Disabled
The Justice Department says Virginia is not being serious enough about efforts to comply with court-ordered reforms to its program for people with disabilities. A letter to the federal judge overseeing a 2012 federal settlement, sent by the Justice Department last month, points as evidence to the way the state has used proceeds from the sale of state-run institutions that treated people with intellectual and developmental disabilities. (Olivo, 7/25)

The Kansas Health Institute News Service: Rethinking Mental Health's Role In Rural Health Care System
A new partnership in southwest Kansas aims to build mental health services and help strengthen a couple of rural hospitals at the same time. The nonprofit United Methodist Health Ministry Fund is leading an effort to make the health system work better for people in rural Kansas. The fund’s president, Kim Moore, said the current structure based on small, low-volume hospitals isn’t likely to survive long-term. (Thompson, 7/24)

The Chicago Sun-Times: Community Wants Roseland Hospital To Stay Open
In the wake of a judge's order that state payments to Cook County hospitals relying heavily on Medicaid funds must continue during the state budget standoff, community leaders rallied at South Side Roseland Community Hospital to demand a resolution that goes beyond that temporary reprieve. (Ihejirika, 7/24)

Los Angeles Times: UC San Diego Wins Legal Battle In Dispute With USC Over Alzheimer's Project
UC San Diego won a major legal battle Friday against USC when a judge ruled that control of a landmark project on Alzheimer's disease belongs to the La Jolla school. The decision addressed the heart of a lawsuit that has gained international attention since UC San Diego filed it early this month, largely because it's rare for such disagreements in the academic world to reach the courtroom. (Robbins, 7/24)

The Statesman Journal: Doctors Are Bringing House Calls Back
Mary Venturacci is 98 years old and lives by herself in her northeast Salem home. It's an ideal situation for most older adults, who prefer to continue living in the comfort of their home and maintain independence. But it takes some work. Much of it falls on her daughter, Wanda Urban, who helps Venturacci with her health care, medications, grocery shopping and more. Another good portion falls on Venturacci's Kaiser Permanente nurse practitioner, Marty Surface, who provides her with primary care services at her home. (Yoo, 7/25)

MinnPost: What It's Like To Be A Paramedic In Hennepin County
From defibrillating heart attack victims to administering morphine to those with extreme burns, the day-to-day encounters of a paramedic run the gamut. Hours of training and several certifications come standard in the emergency medical services field, but one aspect of the job is crystal-clear: “Caffeine is something of a ritual.” Or so it is according to Jordan Wardell, a paramedic for Hennepin County Medical Center for seven years. Average days run eight to 12 hours, although Wardell has spent 24 hours straight on the job at other institutions. (Schaust, 7/24)

Tribune Wire Reports: Brain Disorder Center's Closing Sends Ripples Nationwide
Lakeview is preparing to close after months of scrutiny over allegations of abuse and neglect, including a client death and reports of chronic understaffing. The paucity of such centers for people with extreme brain disorders and related behavioral problems means the closing is sending national ripples through the industry and stressing out families who need to move their love ones from Lakeview, as well as others who have lost yet another option. (7/26)

The New York Times: New Jersey Legislators Propose Law To Protect Nail Salon Workers
State lawmakers in New Jersey proposed legislation on Friday intended to protect nail salon workers from unhealthy working conditions and abusive labor practices. The move followed calls for reform in the industry, and the imposition of stricter rules in New York. The legislation, which was introduced by two Republican state senators, would include stronger enforcement of safety and health standards for workers in licensed nail salons, with random inspections of 5 percent of the state’s salons each year and requirements for ventilation and safety equipment. (Rojas, 7/24)

The Miami Herald: HIV Testing: On The Spot And In The Clubs On South Beach
On Tuesday evening, just outside of Twist nightclub in Miami Beach, Jose Javier and Mikael Kiezer waited for Victor Gonzalez under the gleam of the club’s red neon sign. A few minutes before 10:30 p.m., when Gonzalez appeared, Kiezer pulled a yellow folding sign out of the van parked in front of the club and propped it open to signal the start of the night’s work. “Free and Fast HIV Testing,” it read. The trio wasn’t headed into Twist to party — they work for the non-profit Latinos Salud. They would spend the night raising awareness about how to prevent the spread of HIV while offering rapid testing and handing out condoms outside one of Miami Beach’s well-known clubs. Their busiest time for testing, they said, is midnight or later. (Adams, 7/25)

Medill News Service: More Texans Seeking Treatment For Meth Abuse
A growing number of Texans are seeking treatment for methamphetamine addiction, reversing a downward trend in abuse in the state since a 2006 federal law banned over-the-counter sales of medicine containing the synthetic drug pseudoephedrine. Last year 6,219 Texans sought substance abuse treatment for methamphetamine and amphetamine addiction, up 590 from the previous year, according to the Treatment Episode Survey data from the federal Substance Abuse and Mental Health Services Administration. (Hoerner, 7/26)

The Associated Press: Medical Marijuana Program Changes Take Effect Friday
Changes to Washington’s medical marijuana program take effect on Friday. The Columbian reports that the changes are part of an overhaul recently approved by lawmakers. Post-traumatic stress disorder and traumatic brain injuries will now be considered qualifying conditions for patients hoping to receive a medical marijuana card. (7/24)

The Texas Tribune: In Texas Jails, Hanging Most Common Suicide Method
Texas county jails see 1 million bookings a year, and inmate deaths there are a rarity. But of the 501 inmate deaths that have occurred in county jails since 2009, nearly a third of them — 140 — were by suicide. And most of those suicides were by hanging, with inmates using objects available to them as ligatures: bed linens, clothing, telephone cords and trash bags. (Langford, Busch and Daniel, 7/24)

Editorials And Opinions

Views On The 50th Anniversary Of Medicare And Medicaid

News outlets note the 50th birthday of both Medicare and Medicaid by exploring its current financial health and what the future could hold for the programs.

The Washington Post: Medicare And Medicaid — A Tarnished Triumph
It was exactly 50 years ago this week that President Lyndon B. Johnson flew to Independence, Mo., and, with former president Harry Truman at his side, signed into law the legislation creating Medicare and Medicaid. It was a seminal moment in U.S. political history. (Robert J. Samuelson, 7/26)

The New York Times: Zombies Against Medicare
Medicare turns 50 this week, and it has been a very good half-century. Before the program went into effect, Ronald Reagan warned that it would destroy American freedom; it didn’t, as far as anyone can tell. What it did do was provide a huge improvement in financial security for seniors and their families, and in many cases it has literally been a lifesaver as well. (Paul Krugman, 7/27)

Detroit Free Press: As Medicare Turns 50, It's Time To Expand It
This week marks the 50th anniversary of Medicare and Medicaid. When President Lyndon B. Johnson signed them into law on July 30, 1965, only 56% of Americans 65 years or older were insured, and many were in poverty. Medical and hospital care provided to seniors was often given as charity. Older Americans generally suffered with poor health, and health care disparities were the norm, particularly in the South, where hospitals remained segregated. (7/25)

The New York Times: A Note On Medicare Costs
Medicare is about to turn 50, and while it has brought immense benefits, it has also cost a lot of money. Why? Is it the general rise in health care spending, or some specific government-related inability to limit outlays? (Paul Krugman, 7/26)

The New York Times: The Disappearing Entitlements Crisis
A few years back elite policy discourse in the United States was totally dominated by the supposed entitlements crisis. Serious people all assured each other that history’s greatest menace was the threat posed by the unstoppable growth of Medicare. Medicaid and social security, which could only be tamed by dismantling the legacy of the New Deal and the Great Society, while of course cutting top marginal tax rates. (Paul Krugman, 7/26)

Viewpoints: What's Behind The Push To Repeal The 'Cadillac Tax'; Finding Relief For Retiree Health Costs Borne By Cities And States

A selection of opinions on health care from around the country.

The Washington Post: Don’t Recall The ‘Cadillac Tax’
For five years, Republicans have been trying, unsuccessfully, to repeal Obamacare. But where the GOP has failed, a bipartisan coalition including dozens of Democrats aims to succeed — at least in part. That’s the strange-but-true implication of the new push to repeal the so-called “Cadillac tax” on high-cost employer-paid group health plans. Levied at a rate of 40 percent on the value of a plan that exceeds $10,200 for individuals and $27,500 for families, the tax represents an absolutely crucial reform in the overall Obamacare package. (7/25)

The Wall Street Journal: Relief For Cities’ Budget-Busting Health-Care Costs
The budgets of many cities and states will soon be disrupted by new accounting rules for retiree health plans. Local governments pay most of the health-insurance premiums for their retired employees—for example, from age 50 until Medicare at age 65, and sometimes for life. Nationwide, the total unfunded obligations of these plans are close to $1 trillion, according to a comprehensive recent study in the Journal of Health Economics. (Robert C. Pozen and Joshua D. Rauh, 7/26)

North Carolina Health News: Why Rural Hospitals Are Closing
Rural hospital leaders are quick to blame Medicaid, Medicare and federal regulations for their financial crisis. But the biggest reason so many rural hospitals are in danger of closing is because they don’t have enough patients. And under the current system of government reimbursements, patient stays are what pay the bills. (Wayne Myers, M.D., 7/24)

The News & Observer: Time To End Abuse Of Drug Discount Program
If there’s one universal truth in Washington politics, it’s that policymakers don’t want the public to know about well-intended government programs that have run amok. In March, the health subcommittee of the Energy and Commerce Committee in the U.S. House sought to change that by holding the first hearing on the “340B” drug discount program in nearly a decade. Haven’t heard of 340B? You aren’t alone, but it is one of Washington’s biggest and best-kept secrets. The 340B program was created by the federal government in 1992 to provide discounted pharmaceutical drugs to the country’s poor, uninsured and most vulnerable. The program required Medicaid-participating drug manufacturers to provide discounted outpatient drugs to certain eligible health care entities, such as rural health centers, certain children’s hospitals and cancer hospitals. Those entities could contract with pharmacies to dispense drugs purchased through the program on their behalf. (Bernie Reeves, 7/24)

The New York Times: Helping Patients And Doctors Talk About Death
Medicare announced plans this month to reimburse doctors for talking with patients about what treatments they want — and don’t want — toward the end of life. This sensible, long-overdue proposal is likely to have a very wide impact. About 80 percent of people who die in the United States each year are covered by Medicare, and Medicare policies are often followed by private insurers, some of which already pay for these advance-planning conversations. (7/25)

The Washington Post: The Coming Alzheimer’s Crisis In America
Current quibbling over what Jeb Bush meant when he said it’s time to phase out and replace Medicare — as opposed to “attacking the seniors,” as one woman at a recent event bellowed out — will soon seem quaint against the realities of our future. Never mind projections that the program will be able to finance only 86 percent of its obligations by 2030. Or that by 2050, the number declines to 80 percent, according to a recently released Social Security and Medicare Boards of Trustees report. (Kathleen Parker, 7/24)

The Washington Post: Why Diagnosing Alzheimer’s, While Painful, Has Value
A couple of generations back, two women in my family “lost their minds.” One started wandering in her 60s, the other became obsessed with dolls in her late teens. The wanderer died at home in 1945, and best I can now tell, the regressing teenager died in a sanitarium about the same year. (Dwaine Rieves, 7/24)

The Washington Post: A Better Option For The Mentally Ill
The incarceration of mentally ill inmates is a national epidemic, with local jails in Los Angeles, Chicago and elsewhere now counting among the country’s largest de facto mental institutions. One result has been pressure and proposals to divert some people charged with nonviolent and minor crimes to treatment rather than a cell. (7/25)

The Washington Post: Putting Out The Fire, Next Time
The Ebola virus has not been eliminated from West Africa, but the public health crisis has eased. The virus, for which there is no ready cure, infected more than 27,000 people and caused more than 11,000 deaths since the outbreak began in early 2014. The pain and suffering have been immense. Now it is time to confront another hard problem: addressing the weaknesses in global response that allowed the virus to spread so rapidly. Without the urgency of another outbreak, national governments and the World Health Organization will be disinclined to change the way they do business. But change they must, or there will be another wave of disease, panic and unnecessary death. (7/26)

USA Today: Another Health Care Data Breach
Following close on the heels of the massive data breach at health insurer Anthem, the parade of hackings at major health care providers continues with the recent announcement of a data breach at UCLA Health System affecting 4.5 million people. The hacking appears to have gone on undetected since September of 2014 until its recent discovery. The compromised information is a treasure trove of personal data for identity thieves. It included names, Social Security numbers, medical records, ID numbers and addresses. But, as I always say, things aren't as bad as you think – they are far worse. The stolen data was totally unencrypted making the threat to the people whose data was in the UCLA Health Systems computers more serious. (Steve Weisman, 6/25)

The Baltimore Sun: Why Selling Baby Parts Should Shock No One
What is most shocking about an undercover video of a conversation between Deborah Nucatola, a Planned Parenthood executive, and two antiabortion activists from the Center for Medical Progress (CMP) posing as employees from a biotech firm is why anyone is shocked. CBS, NBC, and CNN all ignored the story during their Sunday morning political talk shows, but not Fox), the discussion centered on the sale of donated tissue from aborted fetuses. Ms. Nucatola says in the video, "We've been very good at getting heart, lung, liver ... so I'm not gonna crush that part, I'm gonna basically crush below, I'm gonna crush above, and I'm gonna see if I can get it all intact." (Cal Thomas, 7/25)