KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Kaiser Health News Original Stories

Political Cartoon: 'Mixed Results'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Mixed Results'" by Harley Schwadron.

Here's today's health policy haiku:

BUGS CARRYING ZIKA VIRUS ARE AN ENTRENCHED ENEMY

Experts use many
Methods to fight the "cockroach"
Of all mosquitos.

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Campaign 2016

At Debate, Clinton Knocks Sanders' Medicare-For-All Plan: 'The Numbers Don't Add Up'

The Democratic candidates sparred over universal health care at their latest debate on Thursday, with Hillary Clinton painting Bernie Sanders' proposal as unrealistic. But Sanders defended his vision, saying "health care is a right of all people."

The New York Times: In Democratic Debate, Hillary Clinton Paints Bernie Sanders’s Plans As Unrealistic
Hillary Clinton, scrambling to recover from her double-digit defeat in the New Hampshire primary, repeatedly challenged the trillion-dollar policy plans of Bernie Sanders at their presidential debate on Thursday night and portrayed him as a big talker who needed to “level” with voters about the difficulty of accomplishing his agenda. ... Throughout the debate, Mr. Sanders demonstrated little capacity to broaden his political message in compelling new directions beyond overhauling the economy, campaign finance and health care. While he noted that his “Medicare for all” program would save the average middle-class family $5,000 a year, he did not present his vision in any new way or frame the issue in personal terms for average voters. (Chozick and Healy, 2/11)

The Associated Press: Debate Takeaways: Clinton, Sanders Appeal To SC, Nevada
Clinton took an aggressive stance on health care from the outset, arguing that Sanders' plan to create a universal health care system by expanding Medicare would undermine Obama's Affordable Care Act. She argued repeatedly that Sanders had failed to provide a specific way to pay for his plan, and turned the exchange into an overall critique of the Vermont senator's proposals. "In my case, whether it's health care, or getting us to debt-free tuition, or moving us toward paid family leave, I have been very specific about where I would raise the money, how much it would cost, and how I would move this agenda forward," Clinton said. Sanders countered that Clinton was not being accurate, casting the fight for universal health care as a matter of courage. He said he was the candidate willing to take on drug companies, the insurance industry and medical equipment suppliers who might be opposed to an overhaul. (2/11)

Reuters: Clinton And Sanders Battle In Debate Over Healthcare, Wall Street Ties
In a sixth presidential debate that featured several sharp exchanges but a more sedate tone than their last meeting, Clinton said Sanders' proposal for a single-payer, Medicare-for-all healthcare plan would mean dismantling Obamacare and triggering another intense political struggle. Sanders said he would not dismantle the healthcare plan known as Obamacare and was simply moving to provide what most industrialized countries have - healthcare coverage for all. (2/11)

USA Today: Clinton On Health Care: 'We Are Not England. We Are Not France'
Perhaps no issue illustrates the philosophical differences Hillary Clinton and Bernie Sanders have to governing more than health care, the issue that led off Thursday's debate in Milwaukee. In detailing their approaches Thursday, Sanders emphasized his view that "health care is a right of all people." ... Clinton countered that she shares the goal of universal health care but that Sanders' plan amounted to starting over on the issue. "We are not England," she said. "We are not France," arguing that the U.S. health care system has historically been an employer-based system and that the focus should be on improving the existing Affordable Care Act. (Allen, 2/12)

The Associated Press: Fact Check: Clinton, Sanders On Health Care, Donors
In their latest debate, Hillary Clinton glossed over the big-money donors juicing her White House ambitions while Bernie Sanders offered disputed numbers behind his plan for a government-financed health system. ... More detail and analysis are needed on Sanders' plan for cradle-to-grave government-financed health care for all. But two early assessments suggest that the accounting comes up short. (2/11)

CNN: Democratic Debate: CNN's Reality Check Team Inspects The Claims
During Thursday's Democratic debate, Hillary Clinton said that "the Affordable Care Act has helped more African-Americans than any other group to get insurance, to be taken care of." While there is no doubt that the Affordable Care Act -- Obamacare -- helped a large number of African-Americans get health insurance, the legislation has actually resulted in more Latino adults gaining coverage than any other group. (Luhby, Cohen, Bohn, Crawford, Vashi, Rose, Bower, LoBianco, Grise, Browne and Grabow, 2/12)

The Washington Post: Sanders Says Single-Payer Health Care Can Happen In His First Term If ‘People Demand It’
Democratic presidential hopeful Bernie Sanders said that he has no hard timetable for moving to a single-payer health-care system if he wins the White House but that he hopes it’s something he could accomplish in his first term. ... In an interview here Wednesday, Sanders acknowledged that his plan wouldn’t pass “on Day One” of his presidency and said the lobbying strength in Congress of the insurance and pharmaceutical industries remains a big impediment. (Wagner, 2/11)

Meanwhile, on the Republican side of the 2016 race, John Kasich fires back after Jeb Bush brings up the Ohio governor's Medicaid expansion decision —

Columbus Dispatch: Kasich Responds To Bush's Attacks On Medicaid Expansion
The race for the Republican presidential nomination erupted in anger as Gov. John Kasich accused Jeb Bush of “trashing” his opponents following the former Florida governor’s criticism of Kasich using federal dollars to expand health coverage to low-income people. Not only did Kasich say Thursday that Bush might tarnish the legacy of a family which has produced two presidents, but John Weaver, Kasich’s top strategist, told reporters on a conference call that Bush’s campaign has “all the joy of the Texas Chainsaw Massacre.” (Torry and Wehrman, 2/11)

Health Law Issues And Implementation

Former Ky. Governor Launches Drive To Stop GOP's Rollback Of Health Care Initiatives

Former Gov. Steve Beshear, a Democrat who helped implement the Affordable Care's Medicaid expansion in the state and set up a highly successful insurance marketplace, is trying to galvanize opposition to his successor's plans to dissolve those programs.

The New York Times: Kentucky Ex-Governor Aims To Halt Rollback Of Obamacare Changes
The former governor who made Kentucky a national leader in health care expansion under the Affordable Care Act is moving to protect that legacy from his successor, who has set out to dismantle parts of it. Steven L. Beshear, the former Democratic governor, announced on Thursday the creation of a nonprofit group, Save Kentucky Healthcare, to marshal opposition to changes being made by Gov. Matt Bevin, a Republican who took office in December. (Perez-Pena, 2/11)

The Associated Press: Health Care Battle Brewing Between Governors In Kentucky
Kentucky's two most recent governors went to war over the state's health care system Thursday, raising the stakes in a battle that could tarnish the legacy of the Obama administration's health care law. Former Kentucky Democratic Gov. Steve Beshear formed a tax-exempt organization that will pay for an online campaign he said will "educate voters" about Republican Gov. Matt Bevin's plans to make fewer people eligible for Medicaid and to dismantle a state program where some can purchase private insurance plans at a discount. Bevin said he was amused that Beshear "seems offended by the idea that I would keep a campaign promise," adding it "tells you a fair bit about ... why I won." (Beam, 2/11)

Louisville (Ky.) Courier-Journal: Beshear Launches Petition To Save Ky Health Care
The campaign comes as Beshear's successor, Gov. Matt Bevin, has announced plans to dismantle Kentucky's nationally known health insurance exchange and restructure the Medicaid expansion Beshear enacted by executive order under the Affordable Care Act. Beshear, on the website, calls on Kentucky to support the changes that have added health coverage to more than 500,000 people and helped Kentucky achieve the sharpest drop of uninsured residents in the nation. (Yetter, 2/11)

Idaho Alternative To Medicaid Expansion Approved By Legislative Committee

The measure would provide some basic health services to those who earn too much to qualify for Medicaid but aren't eligible for premium subsidies under the federal health law. But it wouldn't cover prescription drugs, hospitalization or expensive treatments. Other outlets report on Medicaid expansion efforts in Utah and Virginia.

The Associated Press: Idaho Panel Backs Medicaid Expansion Alternative
Gov. C.L. "Butch" Otter's proposed alternative to Medicaid expansion passed its first hurdle in the Idaho Legislature Thursday. The $30 million plan dubbed the Idaho Primary Care Access Program would provide basic health care services to the estimated 78,000 Idahoans who make too much to qualify for Medicaid but also don't qualify for health insurance subsidies. The measure wouldn't cover expensive treatments, hospitalization and most prescription medications for the gap population and would function by providing primary care clinics with an estimated $32 per month for each indigent patient they treat. (Haake, 2/11)

KSL (Salt Lake City, Utah): Diverse Group Urges Lawmakers To Expand Medicaid
It was a different cast of characters testifying about the need for Medicaid expansion in Utah Thursday. What is typically an unending list of patients pleading with lawmakers to give them access to health insurance, Thursday's meeting was filled with organizational executives, local religious leaders, doctors and other providers, professors and experts, economists and general advocates for Utah's uninsured. (Leonard, 2/11)

The Washington Post: Virginia Poll Shows Partisan Divide On Gun Control, Medicaid
Virginia voters want hospitals to pay for Medicaid expansion, don’t want businesses to deny service to gay customers and do support background checks at gun shows, a new poll shows. Christopher Newport University’s Judy Ford Wason Center for Public Policy surveyed voters on hot-button issues before the General Assembly. ... Support for the general notion of expanding Medicaid under the federal Affordable Care Act stands at 61 percent with support among a majority of African Americans, ideological liberals and Democrats. More than half of Republicans and conservatives oppose extending coverage to 400,000 uninsured Virginians. (Portnoy, 2/11)

Number Of Uninsured Kids Drops Sharply In 23 States Since Health Law's Start

No state saw an increase in uninsured children. Nearly 5 million Americans younger than 19 still lack health insurance though, according to a Robert Wood Johnson Foundation report.

HealthDay: Gains In Kids' Health Coverage Continue, But Many Still Uninsured
Despite a significant increase in the number of American children with health insurance, many still lack coverage, a new study reveals. From 2013 to 2014, the number of uninsured children fell from 5.9 million to 4.9 million. In 2013, 7.5 percent of youngsters were uninsured, compared to 6.3 percent in 2014 -- a 16 percent decrease. (Preidt, 2/11)

Georgia Health News: Georgia Has Fewer Uninsured Kids As ACA Takes Hold
The number of uninsured Georgia children fell by more than 50,000 in 2014, the first year of full implementation of the Affordable Care Act, a new report found. That drop of 53,000 was the fourth-biggest decline in the United States. Yet it left Georgia still having 210,000 kids without coverage, the fourth-largest total in the nation, according to the Robert Wood Johnson Foundation report, released Thursday. (Miller, 2/11)

The Denver Post: Number Of Colorado Kids Without Insurance Dropped By 35,000
The number of Colorado kids without health insurance dropped by 35,000 after federal health care reform, according to a new report from the Robert Wood Johnson Foundation. In 2014, the number of uninsured children in Colorado dropped from 118,000 to about 83,000 after the Affordable Care Act was implemented. (2/11)

Meanwhile, Virginia reports its latest open enrollment numbers —

The Associated Press: Nearly 421,900 Sign Up For Plans On Health Care Marketplace
Gov. Terry McAuliffe says nearly 421,900 Virginia residents have signed up for health coverage through the HealthCare.gov marketplace. The Democratic governor said total enrollment on the marketplace in Virginia this year exceeded the state’s expectations. The figures reflect the number of people who signed up during the latest open enrollment period, which ended Jan. 31. (2/11)

And in news about another key provision of the health law, the Miami Herald examines how the effort to close Medicare's “doughnut hole” in drug coverage impacts Medicare beneficiaries in Florida —

The Miami Herald: Obama Administration: Floridians On Medicare Saved $350M On Prescriptions In 2015
Medicare patients in Florida have received discounts and rebates of $1.3 billion on prescription drugs in the six years since enactment of the Affordable Care Act in 2010, the Obama administration reported this week. The ACA, also known as Obamacare, included changes to Medicare’s prescription drug coverage that gradually reduce the out-of-pocket costs for patients insured under the federal health program for people age 65 and older, and the disabled. (Chang, 2/11)

Marketplace

Despite Boards Stocked With D.C. Luminaries, Theranos Still Faces Consequences From Regulators

The blood testing startup's advisory board includes, among others, former Cabinet secretaries George Shultz, Henry Kissinger and William Perry, former Senate Majority Leader Bill Frist and legal star David Boies. Analysts worry its failure, even with such big names advising it, could cripple investors' enthusiasm for innovative health care companies.

Politico: Troubled Health Start-Up Theranos Faces Washington Reckoning
Theranos, a $9 billion health care startup, is becoming a poster child for the limited value of having a board stocked with Washington powerbrokers. With insiders ranging from Henry Kissinger to former Senate Majority Leader Bill Frist, Theranos still faces a federal regulatory call Friday that could capsize the firm and threaten an innovative healthcare sector along with it. The Palo Alto, Calif., company, headed by 32-year-old Elizabeth Holmes, has faced growing scientific and financial skepticism over its bold central claim: that it can replace the scary hypodermic needle with a cheap finger prick to test human blood, overturning the lab testing industry in the process. (Tahir, 2/11)

Patient First Stops Accepting Some Anthem Plans In Mid-Atlantic Care Centers

In other insurance marketplace news, Centene, a Medicaid coverage provider, stops its search for six missing hard drives that contained personal information for an estimated 950,000 customers. Meanwhile, a new analysis from the Robert Wood Johnson Foundation examines hospital participation in marketplace-plan networks.

The Richmond Times-Dispatch: Patient First No Longer Taking Some Anthem Health Plans In Dispute Over Reimbursements
Patient First, which operates nine urgent and primary care medical centers in the Richmond area and dozens of facilities in the Mid-Atlantic, is no longer accepting some Anthem health insurance plans for payment. Patient First stopped accepting, as of Feb. 2, new patients who are members of Anthem, HealthKeepers and out-of-state BlueCross BlueShield plans except CareFirst Blue Cross Blue Shield. (Smith, 2/10)

The Associated Press: Insurer Centene Ends Search For Missing Hard Drives
Medicaid coverage provider Centene has ended a search for six hard drives that contained the personal information of roughly 950,000 customers more than a month after the equipment turned up missing. The St. Louis-based company said that an employee admitted to placing the six hard drives "in a locked receptacle for secure destruction," according to a brief statement filed Wednesday with the Securities and Exchange Commission. (Murphy, 2/11)

Kaiser Health News: Top Hospitals Likely Are Available On A Marketplace Plan, Study Finds
Despite much hand-wringing over the size and quality of provider networks on the health insurance marketplaces, many top-notch hospitals are available in-network in marketplace plans this year, a new study found. However, more than half of those hospitals participated in fewer plans than last year, limiting their in-network availability to just one marketplace plan in a growing number of cases. (Andrews, 2/12)

Pharmaceuticals

In The UK, GlaxoSmithKline Faces $53 Million Fine Over Generic Drug Delay

The pharmaceutical company was fined by the United Kingdom's Competition and Markets Authority for deals to delay the launch of cheap generic copies of its blockbuster antidepressant Seroxat. The regulator considered the deals to be market abuse, and the action follows steps taken by U.S. and European antitrust regulators.

The Wall Street Journal: GlaxoSmithKline Fined $53 Million In Generic Drug Delay Ruling
U.K. pharmaceutical company GlaxoSmithKline PLC has been fined £37.6 million ($53.7 million) by the U.K.’s Competition and Markets Authority for trying to delay the potential entry of competitors into the U.K. generic-drugs market for antidepressant drug paroxetine. Between 2001 and 2004, GlaxoSmithKline agreed to make payments and provide other benefits, together valued at more than £50 million, to suppliers of generic versions of paroxetine, the CMA said in a news release. (Walker, 2/12)

Reuters: UK Watchdog Fines GSK $54 Million Over 'Pay-For-Delay' Drug Deals
Britain's competition watchdog has fined GlaxoSmithKline $54.4 million for market abuse in striking deals to delay the launch of cheap generic copies of its former blockbuster antidepressant Seroxat. The CMA move is the latest example of regulators trying to curb "pay-for-delay" deals by drug companies and follows previous actions by U.S. and European antitrust authorities. The watchdog first accused GSK of anti-competitive behaviour over Seroxat in April 2013, but it has only now handed out fines. (2/11)

Also, Davita is facing scrutiny by federal authorities -

The Wall Street Journal: U.S. Authorities Investigating DaVita HealthCare Unit
Federal authorities are looking into whether a pharmacy provider owned by DaVita HealthCare Partners Inc. was involved in false claims being filed to the government for prescription medications, the company disclosed on Thursday. Interim Chief Financial Officer James K. Hilger said during a conference call that DaVita executives had contacted the government in September after an internal compliance review found some potential billing irregularities and other issues at its DaVita Rx LLC unit. (Armental, 2/11)

The Denver Post: DaVita's Rx Connect Division Under False-Claims Investigation
DaVita HealthCare Partners Inc., which swung to a fourth-quarter net loss, said Thursday it is setting aside $22.5 million to cover expected damages related to false-claims allegations in its pharmacy business. DaVita disclosed Thursday that its DaVita Rx subsidiary is under investigation for allegations that the division presented false claims for payment to the government for prescription medications. (Wallace, 2/11)

Medicare

Medicare Providers Liable For Six Years Of Overpayments, CMS Final Rule States

The proposed rule would have required providers to report overpayments going back 10 years.

Modern Healthcare: Providers Must Report Medicare Overpayments Going Back Six, Not 10 Years
The CMS has finalized a controversial rule that will require providers to return Medicare overpayments. The Affordable Care Act compels providers to return overpayments within 60 days of identifying them. Failing to report overpayments can result in liability under the False Claims Act. That means a provider could either face financial penalties or be excluded from billing the CMS programs. (Dickson, 2/11)

Public Health And Education

Debate Over Arming Guards At Hospitals Grows With Increasing Number Of Deadly Encounters

Health care professionals are divided over the issue as they weigh the safety of their institution and the possible harm that could befall patients. But for one man who was seeking treatment and ended up with a bullet in his chest, the answer is clear.

The New York Times: When The Hospital Fires The Bullet
Like Mr. Pean, patients seeking help at hospitals across the country have instead been injured or killed by those guarding the institutions. Medical centers are not required to report such encounters, so little data is available and health experts suspect that some cases go unnoticed. Police blotters, court documents and government health reports have identified more than a dozen in recent years. They have occurred as more and more American hospitals are arming guards with guns and Tasers, setting off a fierce debate among health care officials about whether such steps — along with greater reliance on law enforcement or military veterans — improve safety or endanger patients. (Rosenthal, 2/12)

Opioid Treatment Demand Puts Strain On Limited Resources

As the nation fights an epidemic, a shortage of doctors and medication hamper the efforts. Meanwhile, Democrats on Capitol Hill are calling for more funding, but are running up against Republican resistance.

Stateline: Waiting Lists Grow For Medicine To Fight Opioid Addiction
After more than a decade of getting high on illicit opioid painkillers and heroin every day, Christopher Dezotelle decided to quit. ... It’s been five years since Dezotelle started treatment the first time, and he still hustles for drugs every day. Only now, instead of heroin or OxyContin, he’s trying to score buprenorphine, one of three federally approved opioid-addiction medications. He says heroin is much easier to find, and it’s less than half the price of buprenorphine .... Nationwide, a shortage of doctors willing to prescribe buprenorphine, which reduces drug cravings, and a federal limit on the number of patients they can treat, prevents many who could benefit from the addiction medication from getting it. (Vestal, 2/11)

The Associated Press: Dems Seek Drug Abuse Funds As Election-Year Issue Sharpens
Congressional Democrats called Thursday for hundreds of millions in emergency spending to fight drug abuse but ran into Republican resistance as another health issue spiraled into an election-year showdown. With the calendar edging deeper into the campaign season, the latest dispute echoes other clashes over whether the federal government should use more taxpayer dollars to contain the Zika virus and help Flint, Michigan, recover from a public health crisis in which its water system has been contaminated with lead. (Fram, 2/11)

The Huffington Post: Democrats Push $600 Million Emergency Heroin Bill
With Congress gradually edging around to actually treating the opioid and heroin abuse crisis as a crisis, Senate Democrats tried to ratchet up the pressure on Republicans Thursday to put some money into confronting the problem. The move came just after the Senate Judiciary Committee approved a bill called the Comprehensive Addiction and Recovery Act, which aims to shift the federal response away from law enforcement efforts and toward prevention and treatment. (McAuliff, 2/11)

The Hill: Senate Dems Vow Fight Over Drug Abuse Funding
A funding fight is threatening a bipartisan bill aimed at fighting the epidemic of prescription drug and heroin abuse. Senate Democrats said Thursday they will seek to attach $600 million in emergency funding when the bipartisan Comprehensive Addiction and Recovery Act (CARA) comes to the Senate floor after next week’s recess. Democrats said CARA is a good first step, but faulted it for only authorizing new spending, meaning that any dollars actually going out would depend on the appropriations process. They say that emergency appropriations are needed. (Sullivan, 2/11)

And in Massachusetts, dental schools will begin introducing opioid addiction prevention training into their curriculum —

WBUR: Dental Schools To Introduce Training On Opioid Abuse
As he waits on the Legislature to compromise over opioid abuse prevention strategies, Gov. Charlie Baker on Thursday detailed an agreement reached with the deans of the state’s three dental medicine schools to introduce training for opioid abuse prevention and management into their core curriculums. (Murphy, 2/11)

The Boston Globe: Dental Schools Adopt Strategy To Combat Opioid Abuse
The three dental schools in Massachusetts have agreed to teach skills in managing pain, prescribing painkillers, and detecting improper use of those drugs, as part of the effort to combat the state’s opioid crisis. Governor Charlie Baker announced the initiative Thursday. It follows a similar agreement in November among the four medical schools in the state, which adopted a curriculum aimed at equipping doctors to prevent and respond to abuse of powerful drugs. (Freyer, 2/11)

Why Eliminating Zika Mosquito Species Is 'Guerrilla Warfare'

Because of its habits -- such as hiding at night -- the species of mosquito that carries Zika and other viruses is particularly hard to kill. Meanwhile, a research hospital in Texas has signed an agreement with Brazil to develop a vaccine, NIH officials say a vaccine might be ready to test by summer, and the CDC reports that two women who were infected while traveling have had miscarriages.

The Wall Street Journal: Fighting The ‘Cockroach Of Mosquitoes’
Experts working to halt the spread of the Zika, dengue and chikungunya viruses face a stubborn foe in the main mosquito that transmits them, and some of the many methods under consideration for fighting them are stirring controversy. The Aedes aegypti mosquito primarily responsible for spreading these diseases has been called “the cockroach of mosquitoes.” It thrives around people, particularly in the densely packed neighborhoods that are common in the tropics. It bites during the day and hides at night in dark corners, including in closets and under beds. (McKay, Johnson and Jelmayer, 2/11)

The Associated Press: Brazil, Texas State Hospital Reach Deal On Zika Vaccine
Brazil has signed an agreement with a Texas research hospital to develop a vaccine against the Zika virus, the country's health minister said Thursday, adding the goal is for the vaccine to be ready for clinical testing within 12 months. Minister Marcelo Castro said at a news conference that the government will invest $1.9 million in the research, which will be jointly conducted by the University of Texas Medical Branch in Galveston and the Evandro Chagas Institute in the Amazonian city of Belem — two facilities specializing in study of mosquito viruses. (2/11)

The Washington Post: NIH Officials Accelerate Timeline For Human Trials Of Zika Vaccine, Saying They Will Now Begin In The Summer
National Institutes of Health officials said this week that researchers may be closer to developing a Zika vaccine than previously thought and that tests on human subjects could begin in as soon as a few months. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview that government scientists have been able to leverage previous research done on two similar viruses — West Nile and dengue — to very quickly create a hybrid vaccine that targets Zika. (Eunjung Cha, 2/11)

The Hill: Zika Virus Linked To Two Miscarriages In US
Two American women have had miscarriages after being infected with the Zika virus while traveling abroad, the Centers for Disease Control and Prevention (CDC) said Thursday. The two miscarriages are the first linked to the Zika virus in the U.S., CDC spokesman Tom Skinner confirmed to The Hill on Thursday. The virus was found in the women's placentas, he said. (Ferris, 2/11)

Elsewhere, media outlets offer coverage of the Zika virus in states —

The Seattle Times: Amid Zika Fears, Local Family Shares The Reality Of Microcephaly
When Leah and Travis Wright saw news reports about the spread of the Zika virus in Brazil and the suspected tie to a little-known birth defect, no one had to tell them about the devastation caused by microcephaly. The Pasco couple’s daughter, Isla Rose, who turns 2 on Friday, was born with the condition that leaves babies with smaller-than-normal heads, brain damage, and possibly hearing loss and other deficits. (Aleccia, 2/11)

The Walla Walla Union-Bulletin: Oregon Reports Zika-Virus In Woman
Oregon health officials announced Thursday the state’s first confirmed case of the Zika virus. Stressing that there is no danger to the public, Oregon Health Authority Public Health Division officials said a person in Oregon has been diagnosed with a travel-associated Zika virus infection. (Hagar, 2/11)

The Miami Herald: Florida Reports 18 Cases Of Zika Virus, All Acquired Outside State
Zika virus infections in Florida increased to 18 on Thursday, marking the first increase in three days, with the highest number reported among residents of Miami-Dade, where seven cases have been confirmed, the Department of Health said. All of the Zika cases were acquired outside of Florida, and none involves pregnant women, who are considered to be at greatest risk from the virus because of its suspected association with birth defects and neurological disorders. (Chang, 2/11)

The Miami Herald: CDC To Host Zika Virus Conference Call With Florida Health Care Workers
No new cases of Zika infection have been reported in Florida since Monday, but more help is on the way from the federal government as requested by Gov. Rick Scott to prepare for the rapidly spreading virus that appears to pose the greatest threat to pregnant women and their unborn children. The Centers for Disease Control and Prevention will host a conference via telephone and Internet Thursday with Florida obstetricians and gynecologists, family physicians, nurses and other healthcare workers to learn more about how Zika is transmitted, its symptoms, treatments and precautions against the infectious disease. (Chang, 2/10)

The Connecticut Mirror: Pino Named To Lead Public Health, Just In Time For Zika
Gov. Dannel P. Malloy named Dr. Raul Pino to lead the state Department of Public Health on Thursday, then immediately featured him at a briefing on the mosquito-borne Zika virus. Pino and other state officials said Thursday that chances are extremely remote that the virus would be transmitted by any of the 49 species of mosquito found in Connecticut, but his department is getting calls from pregnant women who recently returned from warm-weather areas with a Zika outbreak, which include Puerto Rico. (Levin Becker and Pazniokas, 2/11)

Veterans' Health Care

VA Stands By Limited Agent Orange Benefits Policy

Compensation has been turned down again for Navy veterans who served off the coast of Vietnam, who advocates say were exposed because their ships sucked in potentially contaminated water.

ProPublica: Once Again, The VA Turns Down Navy Vets For Agent Orange Benefits
The U.S. Department of Veterans Affairs has once again turned down an effort by Navy veterans to get compensation for possible exposure to Agent Orange during the Vietnam War. In a document released Friday, the VA said it would continue to limit benefits related to Agent Orange exposure to only those veterans who set foot in Vietnam, where the herbicide was sprayed, and to those who were on boats in inland rivers. The VA compensates these veterans for a litany of associated illnesses, including diabetes, various cancers, Parkinson’s Disease, peripheral neuropathy and a type of heart disease. (Ornstein and Parris, 2/10)

State Watch

Iowa Senate Approves Bill That Would Stop The Transfer Of Medicaid To Managed Care Plans

The measure, however, is not expected to get any traction in the Iowa House.

Des Moines Register: Iowa Senate Votes To Repeal Branstad's Medicaid Plan
The Iowa Senate voted closely along party lines Thursday to repeal Republican Gov. Terry Branstad's plan to have private companies manage Iowa's Medicaid program, which serves 560,000 low-income and disabled people at an annual cost of about $4.2 billion. Senate File 2125, known as the "Health Care Protection Act," was approved on a 29-19 vote. However, the Senate bill — which was proposed by majority Democrats — will be dead on arrival in the Iowa House, which is controlled by Republicans. (Petroski, 2/11)

The Associated Press: Iowa Senate OKs Bill To Dismantle Medicaid Privatization
Plans to switch Iowa's $4.2 billion Medicaid program into private management would be on indefinite hold under legislation passed Thursday in the Democratic-controlled Senate, but the bill is not expected to advance in the GOP-run House. The chamber voted 29-19 for the bill, which would terminate the state's contracts with three private companies hired to take over the program. The one-page bill would essentially direct the Iowa Department of Human Services to give 30 days' written notice to terminate the contracts and pursue "other initiatives to realign the health care delivery system." (Rodriguez, 2/11)

Baptist Health, Memorial Sloan Kettering Announce Miami Cancer Center Partnership

In more state hospital news, Barnes-Jewish Hospital in St. Louis will test patient care in its new, 21-bed neurological wing; and the recently installed New Carolinas CEO Eugene "Gene" Woods offers his thoughts on the future of health care.

The Miami Herald: Baptist Health's Miami Cancer Institute Joins Memorial Sloan Kettering Alliance
The region’s largest nonprofit hospital system, Baptist Health South Florida, announced a high-profile partnership Wednesday with the nationally regarded Memorial Sloan Kettering Cancer Center for the new $400 million Miami Cancer Institute under construction next to Baptist Hospital Miami in Kendall and scheduled to open later this year. The alliance with Memorial Sloan Kettering, whose New York City hospital consistently ranks among the nation’s top cancer treatment centers, will give Baptist Health patients access to Sloan Kettering’s clinical trials, said Michael Zinner, a physician and chief executive of Miami Cancer Institute, in a written statement. (Chang, 2/10)

The St. Louis Post-Dispatch: Barnes-Jewish Hospital Opens New Wing To Test New Care Models
On the 11th floor of Barnes-Jewish Hospital, a bold experiment in patient care is underway. A new 21-bed unit, focused on treating neurological patients, is serving as a way to test different methods of providing care and preparing patients for their return home. Hospital officials even created a special hiring process for the unit, which opened on Jan. 18, with the goal of building a nursing team that could develop innovative approaches for the entire BJC HealthCare system. (Liss, 2/11)

State Highlights: Wis. Assembly Approves Planned Parenthood Cuts; Kan. House OKs Budget Shifting Funds Between Health Concerns

News outlets report on health issues Wisconsin, Kansas, Kentucky, California, Ohio, Nebraska, North Carolina, Massachusetts and Montana.

The Associated Press: Panel Advances Bill To Require Ultrasounds Before Abortions
Abortion opponents increasingly on the offensive in Kentucky’s statehouse advanced legislation Thursday that would require doctors to perform ultrasounds prior to abortions and to describe what is seen to the pregnant women. It’s part of a series of measures being pushed in Kentucky by abortion foes to impose conditions before abortions, ban the sale of fetal body parts and put Planned Parenthood clinics at the end of the line for family planning funds. (Schreiner, 2/11)

Reuters: California Insurance Regulators Probing Zenefits
Software company Zenefits is being investigated by the California Department of Insurance over questions about its business practices, the agency said Thursday. California Insurance Commissioner Dave Jones revealed in a statement that the agency had launched an investigation into Zenefits in 2015. Jones said he had directed the agency to use additional resources to investigate whether Zenefits had complied with regulations that require the licensing and training of insurance agents and brokers. (2/11)

The Associated Press: Cleveland Mayor Apologizes For Billing Family Of Dead Boy
The mayor of Cleveland apologized Thursday to the family of Tamir Rice, a black 12-year-old boy fatally shot by a white Cleveland police officer, for the city having sent the administrator of the boy's estate a "decedent's last dying expense" claim of $500 for ambulance services. Mayor Frank Jackson said at a news conference that filing the claim was part of a routine but that supervisors should have been alerted and the claim never filed. (2/12)

The Associated Press: Opponents Urge Lawmakers To Snuff Out Tobacco Tax Increase
Nebraska's tobacco tax could more than double under a bill that is drawing praise from health officials but strong criticism from retailers, grocers and smokers. A legislative committee heard testimony Thursday on a bill by Sen. Mike Gloor of Grand Island that would bump Nebraska's cigarette tax from 64 cents to $2.14 per pack. It would generate an estimated $120 million in state revenue that would be directed partly to tax relief and partly to health care and public safety providers. (Gronewold, 2/11)

The Associated Press: Jury: Smokers Didn’t Prove Marlboros Have Defective Design
A federal jury has rejected claims by a group of Massachusetts smokers who sued Philip Morris USA to try to force the cigarette maker to pay for lung cancer screenings. The jury in its verdict Wednesday found that smokers in the class-action lawsuit didn’t prove that Marlboro cigarettes were defectively designed. The smokers were not seeking money. Instead, they wanted Philip Morris to pay for a medical-monitoring program, including 3-D chest scans that can detect signs of early-stage lung cancer. (2/11)

North Carolina Health News: Lawmakers Want Mental Health Agencies To Spend Their Money
Even as officials from the Department of Health and Human Services were touting the success and stability of the current mental health system, lawmakers expressed impatience Tuesday morning with the speed of new service creation and denials of service to their constituents. Citing large cash balances held by the state’s mental health managed care organizations, Sen. Tommy Tucker (R-Waxhaw) and other lawmakers said that state-funded local management entities/managed care organizations needed to start spending on patients. (Hoban, 2/11)

The Associated Press: Jury Rules Against Montana Woman’s Wrongful-Birth Lawsuit
A Montana jury ruled Thursday against a woman who sought millions of dollars from health care providers that she said failed to diagnose her unborn daughter’s cystic fibrosis. Kerrie Evans of Gardiner had testified that she would have had an abortion if she had known her daughter, who is now 5 years old, would be born with the genetic disease. The mucus cells of a cystic fibrosis patient produce a thick and sticky fluid that damages the lungs and digestive system. While each case is different, many patients now live to be adults with proper treatment and care. (2/11)

Health Policy Research

Research Roundup: Vaccines For Children Program; Employer Health Plan Differences

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased
The Vaccines for Children program is a US government intervention aimed at increasing vaccination uptake by removing financial barriers that may prevent US children from accessing vaccinations. This study examined the impact that this intervention had on race and ethnicity–related and income-related disparities for diphtheria-tetanus-acellular pertussis, measles-mumps-rubella, and polio vaccinations, using data from the National Immunization Survey, 1995–2013. Vaccination rates increased across all races, ethnicities, and income groups following the introduction of the Vaccines for Children program. Disparities among race and ethnic groups narrowed considerably over time since the introduction of the vaccine program, although income-related disparities changed at different rates within racial and ethnic groups and in some cases increased. (Walsh, Doherty and O’Neill, 2/8)

Health Affairs: Exploring The Impact Of The US Measles Outbreak On Parental Awareness Of And Support For Vaccination
Using two national surveys of parents of children ages five and younger, collected immediately prior to and in the weeks following the 2014–15 US measles outbreak, this study examined the awareness of this vaccine-preventable disease outbreak among parents and whether awareness of the outbreak affected their beliefs about childhood vaccination, confidence, and intentions. The study found that while most parents were aware of the outbreak, many were not, and the level of familiarity mattered, particularly on measures of confidence in vaccines and support for mandates requiring childhood vaccination. Increases in vaccine-related concerns were found as well, indicating that disease outbreaks foster not just awareness of vaccines and their potential to prevent disease but a range of parental responses. (Cacciatore, Nowak and Evans, 2/8)

The Kaiser Family Foundation: A Comparison Of The Availability And Cost Of Coverage For Workers In Small Firms And Large Firms: Update From The 2015 Employer Health Benefits Survey
Accessibility, affordability, and coverage of employer-sponsored health insurance vary greatly for small and large firms. The smallest firms are less than half as likely to offer coverage to their employees as are large firms. While family premiums are less expensive at small firms, covered workers face higher premium contributions and higher cost sharing in the form of higher deductibles. The lower offer rates combined with greater cost-sharing responsibilities for workers in small firms may limit the ability of small firms to attract and retain employees. ... While the[Affordable Care Act] has and will continue to meaningfully impact the availability and scope of insurance coverage, many of the contributing factors to the differences in cost sharing and premiums between small and large employer health benefits are likely to remain. (Long, Rae and Claxton, 2/5)

The Kaiser Family Foundation: Health Care Spending Among Low-Income Households With And Without Medicaid
To gain a better understanding of the impact of insurance on the health care spending and budgets of low-income households, we use data from the 2014 Consumer Expenditure Survey to compare health care spending among low-income households (those with income below 138% FPL or $27,310 for a family of three in 2014) covered by Medicaid to those households not covered by Medicaid. ... Those households with private insurance dedicate a substantial share of their modest budgets to premium and out-of-pocket health care costs—nearly one in every ten dollars (8%). Those households in which all members are covered by Medicaid spend about a tenth of what their counterparts with private coverage spend on health care costs, and devote a much smaller share of their total household budget to health-related expenses. (Majerol, Tolbert and Damico, 2/4)

Morbidity and Mortality Weekly Report: Disparities In Consistent Retention In HIV Care — 11 States And The District Of Columbia, 2011–2013
Among persons with HIV infection diagnosed in 2010 who were alive in December 2013, 38% of blacks with HIV infection were consistently retained in care during 2011–2013, compared with 50% of Hispanics/Latinos (Hispanics) and 49% of non-Hispanic whites (whites). Differences in consistent retention in care by race/ethnicity persisted when groups were stratified by sex or transmission category. Among blacks, 35% of males were consistently retained in care compared with 44% of females. Differences in HIV care retention by race/ethnicity were established during the first year after diagnosis. Efforts to establish early HIV care among blacks are needed to mitigate racial/ethnic disparities in HIV outcomes over time. (Dasgupta, Oster, Li and Hall, 2/5)

Here is a selection of news coverage of other recent research:

Medscape: Therapy, Antidepressants Similarly Effective For Depression
Cognitive behavioral therapy (CBT) is as effective for treating depression as antidepressants, and given its relative lack of potential harms, should be strongly considered as the first-line treatment, according to a new guideline issued by the American College of Physicians (ACP). The guideline is based on a systematic review of randomized controlled trials from 1990 through September 2015 comparing the benefits of second-generation antidepressants (SGAs) and nonpharmacologic interventions such as psychotherapies, complementary and alternative medicines (including acupuncture and St John's wort [Hypericum perforatum]), and exercise. The guideline was published online February 9 in the Annals of Internal Medicine. (Frellick, 2/9)

MedPage Today: Interventions Alter Antibiotic Script Practices
Having to justify an antibiotics prescription for acute respiratory tract infections, or being compared with their peers for number of scripts written, lowered rates of inappropriate antibiotic prescribing practices for up to 18 months among primary care physicians, researchers reported. (Wickline Wallen, 2/9)

Reuters: Drop In Prostate Cancer Screening Reveals Split Among Doctors
After U.S. guidelines advised against routine tests, declines in prostate cancer screening have been sharper among primary care doctors than urologists, according to a new study that suggests the medical community remains divided over the best way to look for these tumors. (Rapaport, 2/8)

Reuters: Emotional Distress Tied To Weapon Use For Teens
Even though a wide range of social and economic factors may influence whether teens get involved with weapons, two things appear to increase the odds for white, black and Hispanic youth alike – emotional distress and substance abuse – a recent U.S. study suggests. Earlier involvement with weapons is also tied to higher future odds of carrying or using a gun or knife for youth in all three groups, the study found. (Rapaport, 2/5)

Editorials And Opinions

Viewpoints: For Sanders And Clinton, More Sparring Over Health Care; Autism As A Campaign Issue

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

U.S. News & World Report: The Problem With Clinton's Health Care Promises
Former Secretary of State Hillary Clinton and independent Sen. Bernie Sanders revived their oft-contentious sparring over health care Thursday night in Milwaukee during the latest Democratic presidential debate, this one on PBS. It was the first debate since Sanders' big win in the New Hampshire primary on Tuesday, and the last before the candidates compete again in the Nevada caucus on Feb. 20. For Sanders, the debate was an opportunity to keep the Bernie train rolling after an impressive victory; for Clinton, it was a chance to step in and re-take control of a race in which she is still the front-runner, but that is looking more complicated than it once did. (Pat Garofalo, 2/12)

The Boston Globe: Can America Afford Sanders’ Big Plans?
Vermont Senator Bernie Sanders has some big plans for America, including ending the reign of money in politics and reshaping the US economy. But sweeping changes like single-payer health care, free college tuition, and guaranteed parental leave don’t come cheap. They require an abundance of new tax dollars, not just from the rich but from virtually all classes of society. (Evan Horowitz, 2/11)

The Washington Post: Five Tips For Candidates Who Want To Talk About Autism — Responsibly
So far this election cycle, Hillary Clinton has been the only candidate to offer a detailed position on autism. Odds are she won’t be the last, considering that the Centers for Disease Control and Prevention estimates that there are more than 3 million Americans with a diagnosis of autism spectrum disorder, and most of those people have families. That’s a constituency worth wooing. But let the wooers be warned: Autism has its own politics, and they are fraught. (John Donvan and Caren Zucker, 2/11)

The Washington Post: NIIT-Picking To Sustain Medicare
There are three ways to increase the sustainability of Medicare, the deservedly much-loved program that provides affordable, quality health coverage to almost 50 million mostly older Americans: cut spending, raise more revenues and/or slow the growth of health costs. (Another way would be to deport the aging boomers who are increasingly coming onto the Medicare rolls, but while I should technically recuse myself from that solution, let’s just not go there.) (Jared Bernstein, 2/11)

The Des Moines Register: BMI Not Reliable Health Measure
“Wellness programs” offered by employers are all the rage. Intended to improve workers’ health and hold down insurance costs, they are broadly defined. As one shrewd researcher told a Register editorial writer: “If you’ve seen one wellness program, you’ve seen one wellness program.” And workers are frequently not interested in participating. (2/11)

The New England Journal of Medicine: Standardizing Patient Outcomes Measurement
If we’re to unlock the potential of value-based health care for driving improvement, outcomes measurement must accelerate. That means committing to measuring a minimum sufficient set of outcomes for every major medical condition — with well-defined methods for their collection and risk adjustment — and then standardizing those sets nationally and globally. (Michael E. Porter, Stefan Larsson and Thomas H. Lee, 2/11)

The Washington Post: It’s Time To Break The Teeth-Whitening Monopoly
It is frequently said that, unfortunately, Americans disdain government. It is more usefully said that, unfortunately, they have abundant reasons for doing so. In coming days, the Supreme Court, by deciding to hear a case from Connecticut, can begin limiting a contemptible government abuse that the court’s passive deference to legislatures has encouraged. The case concerns a minor economic activity, teeth whitening, but a major principle: Can a state limit Americans’ opportunities by restricting access to particular professions for no reason other than the enrichment of people entrenched in those professions? (George F. Will, 2/10)

The New England Journal of Medicine: A World Free Of Polio — The Final Steps
As of January 2016, endemic transmission of polio caused by wild polioviruses (WPVs) had been interrupted in all countries except Pakistan and Afghanistan ... Getting to this point has not been easy. Sustaining our wins and traversing the last mile of the eradication journey calls for escalation of global immunization activities on an unprecedented scale. (Manish Patel and Walter Orenstein, 2/11)

Miami Herald: A Do-Over On Medical Marijuana For Florida
It’s déjà vu all over again for Florida’s controversial medical marijuana amendment, which is back on the ballot in November, two years after it failed, barely, to get the necessary votes. Back then, the measure received 58 percent approval — just short of the 60 percent required for an amendment to pass. But this time, there’s a different political scenario. A presidential election likely will double voter turnout — and the chances for the amendment’s passage. (2/11)

The Wichita Eagle: Local Entrepreneur Reshaping Health Care
Though the debate over the future of the Affordable Care Act almost certainly will rage on whatever the outcome of the 2016 elections, everyone seems to agree that the future growth rate in health care costs, which historically has outpaced general inflation, must somehow be reined in. (Robert Litan, 2/11)