KHN Morning Briefing

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Political Cartoon: 'You Have No Idea'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'You Have No Idea'" by Hilary Price.

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The PACE is faster
To chase profits over care.
Put needs first... Bingo!!

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Summaries Of The News:

Health Law Issues And Implementation

Some Steep Premium Increases Seen As States Begin To Approve Insurers' Rate Plans

The numbers for 2017 premiums for marketplace plans are slowly coming out and show a wide range of increases. Tennessee authorities approved a 62 percent increase for one of the state's biggest plans, while in Ohio the hikes start at more than 12 percent. Other insurance news from Illinois and Wisconsin.

The Wall Street Journal: States Start To Approve Steep Increases In Health Premiums
The first handful of states have released approved 2017 rates for people who buy health insurance on their own and the results so far are consistent with what many expected: There are significant increases in premiums for next year. ... Some insurance regulators have begun announcing their approval of rate increases, including an average jump of 62% for the biggest plan in Tennessee and increases of around 43% in Mississippi and 23% in Kentucky for large carriers. ... Health plans, stung by large losses in the rocky early years of implementation of the 2010 health law, say they need to raise prices substantially to keep their offerings afloat. Federal officials say some increases reflect the planned end of provisions in the law designed to cushion insurers. They say other shifts are predictable as plans adjust to the law’s overhaul of insurance pricing to require it to be sold equally to all customers regardless of medical history or risk. (Radnofsky and Armour, 8/24)

Columbus Dispatch: Despite Increases, Feds Say Obamacare Remains Affordable For Ohio Enrollees
Ohioans insured through the Affordable Care Act will have fewer providers to choose from next year and will pay more for coverage. People insured through the federal exchange in Ohio will see premiums increases of 12.6 percent or higher in 2017 than they paid this year, according to the Ohio Department of Insurance. And the 17 insurance companies that offered coverage on the federal exchange will dwindle to 11 in 2017, according to the department. (Sullivan, 8/24)

Chicago Tribune: Illinois Submits Obamacare Insurance Premium Increases To Feds 
Illinois consumers are one step closer to facing sky-high increases for individual health insurance plans purchased through the Affordable Care Act's marketplace. The Illinois Department of Insurance said Wednesday it has submitted rate increases to the federal government that for some types of plans average 43 percent to 55 percent. (Schencker, 8/24)

Milwaukee Journal Sentinel: MHS Health To Drop ACA Plans In State
MHS Health Wisconsin, the brand name for Managed Health Services, is pulling out of the Wisconsin market for health plans on the marketplaces set up through the Affordable Care Act next year. The health plans are sold under the name Ambetter. In a statement, MHS Health Wisconsin said it has notified the people enrolled in the health plans that their coverage will expire at the end of the year. (8/24)

The Fiscal Times: The Latest Sign That The Obamacare Exchanges Aren’t Working In Many Markets 
In the wake of Aetna’s recent announcement that it was pulling up stakes in 11 of 15 states where it had been selling insurance on Obamacare exchanges, there are more alarming signs that other major insurers are struggling to remain in the game. On Tuesday, three of the major players in Tennessee — Cigna Health Insurance, Humana and Blue Cross Blue Shield — were granted huge double-digit premium increases for the 2017 season beginning in January amid a warning from the state’s insurance commissioner that the Obamacare markets were “very near collapse.” (Pianin, 8/24)

HHS Analysis Says Subsidies Will Help Buffet Consumers From Marketplace Turmoil

The government analysis finds that subsidies to help pay premiums will protect people buying coverage on the health law's marketplaces even as the number of insurers offering plans decreases and insurers set steep premium increases.

Bloomberg: Obamacare Subsidies Preserve Access As Premiums Climb, U.S. Says
Most buyers of Obamacare plans won’t see their costs jump, even if premiums increase next year, because of government subsidies, the U.S. said in a study that pushes back on reports of challenges facing the health-coverage overhaul. Government contributions to premiums will mask the rise in costs for most buyers on the program’s exchanges, according to the report from the U.S. Health and Human Services Department. The study comes amid mounting reports of skyrocketing premiums. (Tracer, 8/24)

The Hill: White House: Most ObamaCare Users Will Be Shielded From Premium Spikes 
The White House released data Wednesday showing the vast majority of ObamaCare customers would be shielded from double-digit premium hikes that are expected to hit most of the country this fall. Even if premiums increased by a whopping 50 percent, most ObamaCare customers would still pay $100 or less per month for coverage, according to a 12-page report by the Department of Health and Human Services (HHS). (Ferris, 8/24)

Morning Consult: HHS Report: Most Marketplace Consumers Will Have Affordable Coverage Options
“Headline rate increases do not reflect what consumers actually pay,” Kathryn Martin, acting assistant secretary for planning and evaluation, said in a statement. “Our study shows that, even in a scenario where all plans saw double digit rate increases, the vast majority of consumers would continue to have affordable options.” Shopping around on the marketplaces can keep health insurance affordable because consumers can easily search for the cheapest plan each year, the report says. (McIntire, 8/24)

Chicago Tribune: Feds Aim To Calm Fears Over Possible Obamacare Rate Hikes 
Even if health insurance rates skyrocket by 10 to 50 percent next year, about two-thirds of Illinois residents who buy coverage through the Affordable Care Act's marketplace would pay no more than $100 a month in premiums, the federal government said Wednesday. That's because consumers could shop around on the marketplace and because premium tax credits would also increase and be available to more people, according to the U.S. Department of Health and Human Services report. (Schencker, 8/24)

Dallas Morning News: HHS Department: Fear Not, Obamacare Will Remain Competitive 
Despite recent decisions by several health insurers to stop offering plans in Texas on the Obamacare marketplace in 2017, federal officials say consumers will continue to have low-cost options. An estimated 80 percent of those who purchase health coverage on during open enrollment should be able to purchase a plan for less than $75 per month. That's even in a hypothetical scenario where final rates from insurers increase 50 percent, the U.S. Department of Health and Human Services said Wednesday. (Rice, 8/24)

Houston Chronicle: Feds Say ACA Working Despite Insurers' Exodus From Exchange
The U.S. Department of Health and Human Services sought to reassure a worried and sometimes disgruntled public on Wednesday, insisting there will still be a robust selection of affordable health insurance plans next year on the federal exchange despite the recent defections by major insurers. Just last week Aetna said it would no longer be offering plans on the Affordable Care Act's exchange next year in 11 states, including Texas. (Deam, 8/24)

St. Louis Post Dispatch: Feds Tout Exchange Benefits Despite Lack Of Competition For 2017 
Despite the withdrawal of some insurers from government-run health insurance exchanges, federal officials insist the Affordable Care Act is still working to provide more consumers with coverage and choices. ...The administration of President Barack Obama has been pressed to defend the landmark health care reform in recent weeks as major companies move to dramatically reduce their participation in the exchanges, including in Missouri. (Liss, 8/25)

Kentucky's Medicaid Overhaul Plan Proposes Work Requirements And Premiums

Gov. Matt Bevin's administration submitted the waiver request to the federal Department of Health and Human Services for review and approval. The Obama administration has previously balked at similar provisions in another request that would require recipients to work or volunteer 20 hours a week.

Lexington (Ky.) Herald-Leader: Gov. Bevin Submits Medicaid Overhaul Plan To Feds, With Some Changes
The revised plan Bevin sent to the U.S. Department of Health and Human Services — which he calls Kentucky HEALTH — had a handful of changes that he said are a response to public criticism of the original waiver proposal he unveiled in June. Over the next five years, it could shave $2.2 billion off the expected $37.2 billion expense of Kentucky’s Medicaid program, according to the waiver application. Speaking to reporters, Bevin said there is not much room on his side for compromise if HHS wants changes. (Cheves, 8/24)

Louisville (Ky.) Courier-Journal: Controversial Parts Of Medicaid Plan Remain
Gov. Matt Bevin's administration unveiled its long-awaited plan to reshape the state's Medicaid program Wednesday, and while it restores some benefits Bevin proposed be cut two months ago, it retains the most controversial components of the governor's approach to overhauling the federal-state health plan for low-income and disabled Kentuckians. (Loftus and Yetter, 8/24)

The Hill: Kentucky Submits Controversial Plan To Overhaul Medicaid 
Kentucky’s Republican governor, Matt Bevin, on Wednesday submitted his plan for overhauling the state’s Medicaid program under ObamaCare, setting up a potential showdown with the Obama administration. Bevin, a fierce opponent of the healthcare overhaul, was elected last year and has promised to change the state’s expansion of Medicaid that came as part of the federal health law. (Sullivan, 8/24)

Morning Consult: Kentucky Governor Submits Medicaid Expansion Waiver To HHS
Kentucky Gov. Matt Bevin (R) on Wednesday submitted a waiver to the Department of Health and Human Services seeking to overhaul the state’s expanded Medicaid program. The state’s proposal seeks to transition people on Medicaid to private insurance plans and help pay for the state’s expanded Medicaid program, Bevin said when he announced the plan in June. Kentucky officials have since made some changes and clarifications to the proposal, after holding public hearings and collecting comments over the past two months. (McIntire, 8/24)


Pricing Backlash Spurs Mylan To Offer EpiPen Discounts For Some Groups

The drugmaker announces that it will increase the amount on a copay savings card from $100 to $300 and expand eligibility criteria for patients who can receive the drug for free.

The New York Times: Mylan To Lower EpiPen Cost For Some Patients
Responding to a growing furor from consumers and politicians, the pharmaceutical company Mylan said on Thursday that it would lower the cost to some patients of the EpiPen, which is used to treat life-threatening allergy attacks. The company said it would take immediate action, including providing a savings card that would cover up to $300 of the cost of a pack of two EpiPens, an increase from the $100 savings card it had been offering. (Pollack, 8/25)

Stat: Under Fire, Mylan Takes Steps To Make $600 EpiPen More Affordable
In the face of withering criticism, Mylan Pharmaceuticals took steps Thursday to make its EpiPen device more affordable. Specifically, the company is increasing the amount of money on a copay assistance card from $100 to $300, and is also widening eligibility for patients to receive the device through that assistance program. “We recognize the significant burden on patients from continued, rising insurance premiums and being forced increasingly to pay the full list price for medicines at the pharmacy counter. Patients deserve increased price transparency and affordable care, particularly as the system shifts significant costs to them,” Mylan chief executive officer Heather Bresch said in a statement. (Silverman, 8/25)

Reuters: Mylan Offers Discounts On EpiPen After Clinton Criticism
Mylan NV said on Thursday it would reduce the out-of-pocket cost of its severe allergy treatment EpiPen through a discount program, a day after Democratic Presidential candidate Hillary Clinton joined lawmakers in criticizing the drug's high price.The company, which did not lower the drug's list price, said it would reduce the patient cost of EpiPen through the use of a savings card, which will cover up to $300 of EpiPen 2-Pak. (Banerjee, 8/25)

The Wall Street Journal: Mylan Boosts Assistance For EpiPen After Pricing Backlash
After widespread criticism recently, Mylan said Thursday it would expand access and increase benefits to programs that it uses to help consumers pay less, but those changes wouldn’t alter the prices that insurers and employers pay. Those institutions will still face the brunt of the impact from the price hikes, though they are frequently able to privately negotiate cheaper prices than the ones listed. (Hufford and Rockoff, 8/25)

EpiPen's Pricetag Quickly Becomes Latest Outrage In Drug-Pricing Debate

Under the weight of the criticism, stock prices for Mylan, the manufacturer of the Epi-Pen, fell 5.4 percent on Wednesday and 4.8 percent the day before. Meanwhile, news outlets examine the steps that led to the dramatic price increase and reaction from policy makers and even local physicians.

The New York Times: The Complex Math Behind Spiraling Prescription Drug Prices
The soaring cost of prescription drugs has generated outrage among politicians and patients. Some cancer drugs carry price tags of more than $100,000 a year, and health plans are increasingly asking people to shoulder a greater share of the cost. The latest outrage involves the price of EpiPen, a lifesaving injection device for people with severe allergies, which has risen to more than $600 for the list price of a two-pen set, from less than $100 when Mylan acquired the product in 2007. (Thomas, 8/24)

The Wall Street Journal: Mylan Faces Scrutiny Over EpiPen Price Increases
Mylan pointed to a statement saying it was committed to ensuring patients have affordable access to the drug, and the company has given away more than 700,000 EpiPens to schools while paying all the out-of-pocket costs of 80% of commercially insured patients. The criticism has taken a toll on Mylan, whose stock fell 5.4% on Wednesday after a 4.8% drop the day before. (Rockoff, 8/24)

NPR: Latest Target In The Drug Price Wars? The Ubiquitous EpiPen
EpiPens are in your friend's purse and your kid's backpack. The school nurse has a few, as does Grandma. The medicine inside — epinephrine — has been around forever, and the handy gadget that injects it into your leg is not particularly new either. So members of Congress, responding to their angry constituents, want to know why the price of the EpiPen, which can reverse a life-threatening allergic reaction, has risen about fivefold in the past decade. (Kodjak, 8/24)

The New York Times: Mylan Raised EpiPen’s Price Before The Expected Arrival Of A Generic
In 2012, the company behind the EpiPen settled a lawsuit by agreeing to allow a generic competitor into the market in 2015, potentially cutting into a big part of its business. The company, Mylan, had already been steadily increasing the price of EpiPen, an injector containing a drug that can save people from life-threatening allergy attacks. After the settlement, it started to raise the price even faster. (Pollack, 8/24)

Stat: Mylan Price Hikes On Many Other Drugs Eclipsed EpiPen Increases
EpiPen price hikes may be causing outrage, but those pale in comparison to the huge increases that Mylan Laboratories took on dozens of other medicines earlier this year. For instance, the company raised the price of ursodiol, a generic medicine used to treat gallstones, by 542 percent. There was also a 400 percent boost in the price for dicyclomine, which combats irritable bowel syndrome, and a 312 percent increase for metoclopramide, a generic drug that treats gastroesophageal reflux disease. (Silverman, 8/24)

Orlando Sentinel: Local Doctors Concerned About EpiPen Price Increase 
With some parents panicking over the skyrocketing price of life-saving EpiPens, local doctors are frustrated that they can't offer an alternative prescription to patients. "Usually when someone can't afford one type of antibiotic, we prescribe them another one. But here there's no alternative," said Dr. Steven Rosenberg, a senior physician at Allergy, Asthma & Immunology Associates of Central Florida. (Miller, 8/24)

Mylan's Marketing Of EpiPens To Schools Now Part Of Growing Price Controversy

Stat reports that some legal analysts say that Mylan's provision of its emergency allergy treatment to schools at a discounted price may have been an antitrust violation. Meanwhile, senators who backed legislation encouraged schools to stock the EpiPen are now among those calling for an investigation of the product's price hike.

Stat: Mylan May Have Violated Antitrust Law In Its EpiPen Sales To Schools
Schools across the country keep EpiPens in their nurses’ offices in case a student has a severe allergic reaction. For years, Mylan Pharmaceuticals has been selling the devices to schools at a discounted price, giving them a break from rising costs. But the program also prohibited schools from buying competitors’ devices — a provision that experts say may have violated antitrust law. (Swetlitz and Silverman, 8/25)

The CT Mirror: Blumenthal, Others Who Helped Sales Of EpiPen, Want Probe Of Price Hikes
Like other lawmakers now calling for an investigation of the massive hikes in the price of EpiPens, Sen. Richard Blumenthal backed legislation that encouraged schools to stock the auto-injector that delivers a drug that counters the effects of a potentially fatal allergic reaction. In 2013, Blumenthal was an original co-sponsor of a bill – which became law – that awards grants to states that require their public elementary and secondary schools to maintain a supply of emergency epinephrine, the drug delivered by EpiPens. (Radelat and Constable, 8/24)

In related news --

Stat: Senators Demand Face-To-Face Meeting With EpiPen Maker
File this under “Another day, another lawmaker is leaning on Mylan Laboratories.” The US senators who head the Special Committee on Aging are the latest politicians to demand the company explain the pricing behind its EpiPen injector for allergic reactions. And not only does the committee want Mylan to provide information reviewed by its board of directors, the committee also asked the drug maker to schedule a face-to-face briefing over the next two weeks. (Silverman, 8/24)

Awkward Connection: Mylan CEO Is Senator's Daughter

As lawmakers on Capitol Hill increasingly call for an investigation regarding the soaring costs of Mylan Pharmaceuticals' EpiPen, there is a twist. The company's CEO is Heather Bresch, who is the daughter of Sen. Joe Manchin, D-W.Va.

The Washington Post: CEO At Center Of EpiPen Price Hike Controversy Is Sen. Joe Manchin’s Daughter
The growing congressional scrutiny of pharmaceutical giant Mylan over the high cost of EpiPens could prove awkward for Sen. Joe Manchin. The West Virginia Democrat’s daughter, Heather Bresch, is chief executive of the company, which appears to have hiked the price of the epinephrine auto-injector by 400 percent since 2007. The device, which is used to treat severe allergic reactions, now costs more than $600 per dose. (Ho, 8/24)

The Associated Press: Sen. Manchin Mum On EpiPen Hikes By Daughter's Drug Company
U.S. Sen. Joe Manchin remained mum Wednesday as a pharmaceutical company run by his daughter faced mounting criticism for hiking prices on life-saving allergy injection pens. ... His silence contrasted with a growing number of leaders crying foul on the ballooning prices, including fellow senators and the presidential candidate Manchin has endorsed, Hillary Clinton. (Mattise , 8/24)

Campaign 2016

Clinton Joins Lawmakers Slamming EpiPen Pricing, Endorses Creation Of Emergency Health Fund

Prescriptions drug costs, how to handle public health crises like Zika and Ebola and the candidates' health records all make headlines from the presidential campaign trail.

Bloomberg: Clinton’s Attacks On Drug Pricing Leave Health Stocks Reeling
Drugmakers are learning to duck for cover when Hillary Clinton puts them in her sights. The Democratic presidential nominee’s influence was on display again Wednesday, when she sent Mylan NV’s shares plummeting as much as much as 6.2 percent within minutes of calling for the company to drop prices of its EpiPen emergency allergy shot. It marked the third time over the past year that Clinton’s comments roiled drug stocks. (Edney, 8/24)

Morning Consult: Clinton Joins Outcry Against EpiPen Price Hike
Hillary Clinton called the massive increase in the price of EpiPens “outrageous” on Wednesday, joining a growing group of lawmakers and industry groups responding to the latest drug pricing scandal. Mylan Pharmaceuticals, the manufacturer of EpiPens, has raised the price of the drug/dispenser used for emergency allergic reactions by more than 400 percent since 2009, even though the product remains unchanged. It now costs as much as $600 for a pack of two EpiPens, which must be replaced every 12 to 18 months. (Owens, 8/24)

The Hill: Clinton Sides With GOP On Emergency Health Fund 
Democratic presidential nominee Hillary Clinton vowed Wednesday to create a public health emergency fund that she says would have averted the yearlong fight in Congress over funding to combat the Zika virus. Clinton is endorsing an idea long supported by Democrats — and, more recently, by Republican leadership in Congress. Last month, GOP leaders set aside $300 million for the nation’s first emergency public health fund in one of the pending government spending bills for next year. The proposal is dubbed the “FEMA for public health,” a reference to the Federal Emergency Management Agency, which helps communities hurt by disasters. (Ferris, 8/24)

Morning Consult: Clinton Proposes Fund For Public Health Emergencies
Hillary Clinton on Wednesday proposed the creation of a public health emergency fund to help the U.S. more quickly respond to emergencies like the Zika virus. A Public Health Rapid Response Fund with an annual budget allocation would help federal agencies more quickly respond to public health crises and could support research for emerging diseases, Clinton said in a statement. The proposal comes as lawmakers have been at odds over allocating funding for the Zika virus, as the number of people infected with the mosquito-borne virus continues to grow. (McIntire, 8/24)

The Associated Press: Clinton Proposes New Federal Fund To Combat Zika Virus
As the Zika virus continues to spread, Hillary Clinton is proposing a new fund to improve the federal government's response to major public health crises. The Democratic presidential nominee says the U.S. is failing to sufficiently invest in public health preparedness, not only for Zika, but health threats from potentially pandemic diseases, climate change and possible bioterrorism. (Lerer, 8/24)

The Washington Post: Trump Wanted To Keep Americans Critically Ill With Ebola Out Of The U.S.
Two years ago this month, the Ebola crisis in West Africa burst into American consciousness when a pair of U.S. health workers became critically ill battling the epidemic and health officials raced to bring them home for treatment. The pair, physician Kent Brantly and nurse Nancy Writebol, almost surely would have died if they hadn’t been airlifted from Monrovia, Liberia, to a special facility in Atlanta, where they eventually regained their health. Or if U.S. officials had listened to one of the loudest voices of opposition to that move: Donald Trump. (Bernstein, 8/24)

The Hill: Trump Campaign Manager: 'Perhaps' He Should Release Medical Records 
Donald Trump's new campaign manager on Wednesday night acknowledged that the GOP presidential candidate may need to release a more detailed medical statement than the glowing report previously published. "Doesn't he owe it to the American people to release an actual medical report, a more credible, more complete statement?" Rachel Maddow asked Kellyanne Conway on her MSNBC show. "Perhaps," Conway responded, before quickly moving onto discussing Hillary Clinton's health. (Byrnes, 8/24)

Public Health And Education

Report From Brazil: Baby With Zika Stayed Infected For Two Months After Birth

This information is viewed as more bad news because it suggests that the virus may continue to cause damage during this time when the brain is rapidly growing and developing.

NBC News: More Bad Zika News: Affected Newborn Stayed Infected For Two Months
A Brazilian baby with brain damage caused by Zika virus stayed infected for more than two months after he was born, doctors reported Wednesday. That suggests that newborns may continue to be at risk from the virus at a time when their brains are still rapidly growing and developing. It's another unpleasant surprise about Zika, the once-uninteresting virus that keeps throwing curveballs at researchers. (Fox, 8/24)

Stat: Can Zika Virus Damage An Infected Infant’s Brain After Birth?
A new report from Brazil raises questions about whether the Zika virus can continue to damage an infected infant’s brain after birth. An infant in Sao Paulo whose mother was infected late in her second trimester was born without any visible birth defects. But testing showed the baby had the Zika virus in his blood; the virus remained in his system for at least a couple of months. At six months, it became apparent that the child had suffered Zika-related brain damage. He had severe muscle contractions — a common sign of brain damage — on one side of his body. (Branswell, 8/24)

Also in the news -

The Baltimore Sun: Hopkins To Open Multidisciplinary Center Focused On Zika
Johns Hopkins Medicine plans to open what officials said will be the world's first multidisciplinary Zika center, allowing infected patients to get care and researchers to investigate the virus in one place. The rapid spread of the Zika virus has alarmed public health officials and doctors because the mosquito-borne virus causes microcephaly, which stunts the brains and skulls of fetuses in infected pregnant women, and potentially causes other birth defects. Infection also has been connected to stillbirths and miscarriages.  (Cohn, 8/24)

As Fla. Scrambles To Fight Zika, Concerns Emerge About Chemicals Being Used, Other Strategies

NBC News reports that the state is using a chemical that has been banned in Europe, and The New York Times reports on how some people are growing uneasy about the roles of science and government. Meanwhile, attention is now focusing on the need for more information related to the first non-travel case of Zika identified in the Tampa area.

The New York Times: In Florida Keys, Some Worry About ‘Science And Government’ More Than Zika
So when, several years ago, the Florida Keys Mosquito Control District offered up the peninsula of Key Haven, a tiny suburb of Key West, for the first United States test of genetically modified mosquitoes built to blunt the spread of dengue and Zika, it was only a matter of time before opposition mounted. Today, even as federal officials have told pregnant women to stay away from parts of Miami-Dade County because of the Zika virus, Key Haven’s hardened position against the trial — or the experiment, as they call it — is hard to miss amid the bougainvillea and hibiscus flowering on lawns here. “No Consent to Release of Genetically Modified Mosquitoes,” red-and-white placards declare. (Alvarez, 8/24)

Health News Florida: Rep. Jolly Pushing For Location Of Pinellas Zika Transmission
With the first locally-transmitted case of Zika in Tampa Bay the question on everyone’s minds is where?Rep.  David Jolly, who represents Pinellas County, is pushing for an answer. It took 11 days for officials to say where in Miami the first locally-transmitted cases of Zika were detected.  And that was only after the virus had spread. Jolly doesn't want that to happen here. (Ochoa, 8/24)

NPR: Florida Doctors Outline Zika Risks In Treating Pregnant Patients
Being pregnant can be stressful. ... And now, some women and their partners have to consider the risks of Zika, especially in Florida where local mosquitoes have transmitted the virus. Elizabeth Etkin-Kramer is hearing more and more questions about Zika from her patients. She is an OB-GYN whose office is in Miami Beach which is one of the affected areas. (McEvers, 8/24)

Study Finds Strong Evidence Of Increased Cancer Risk Linked To Obesity

An earlier review by the International Agency for Research on Cancer linked excess body fat to five types of cancer, while its latest study adds eight more to that list. In other news on the disease, media outlets report on a gene test that may help predict when a woman with breast cancer can skip chemotherapy.

The New York Times: Obesity Is Linked To At Least 13 Types Of Cancer
This new review, published in The New England Journal of Medicine, links an additional eight cancers to excess fat: gastric cardia, a cancer of the part of the stomach closest to the esophagus; liver cancer; gallbladder cancer; pancreatic cancer; thyroid cancer; ovarian cancer; meningioma, a usually benign type of brain cancer; and multiple myeloma, a blood cancer. (Bakalar, 8/24)

The Washington Post: Gene Test Can Reduce Chemo Use Among Breast-Cancer Patients, Study Says
Doctors have long known that many early-stage breast cancer patients who undergo chemotherapy don't actually need it to prevent recurrence of the disease after surgery. But they haven't known exactly which patients might safely skip the toxic treatment. A European study published Wednesday in the New England Journal of Medicine sheds new light on the issue, concluding that many such patients might be able to avoid chemo. (McGinley, 8/24)

NPR: Precision Test For Breast Cancer Treatment Remains Imprecise
A major study about the best way to treat early-stage breast cancer reveals that "precision medicine" doesn't provide unambiguous answers about how to choose the best therapy. "Precision doesn't mean certainty," says David Hunter, a professor of cancer prevention at Harvard's T.H. Chan School of Public Health. That point is illustrated in a large study published Wednesday in the New England Journal of Medicine, involving decisions about chemotherapy. (Harris, 8/24)

KQED: With Gene Test, Some Breast Cancer Patients Can Skip Chemo: Study
In a boost for the concept of precision medicine and genetic testing, a major study published in The New England Journal of Medicine Wednesday has found that some early-stage, post-operative breast cancer patients can avoid potentially dangerous and expensive chemotherapy with only a slightly lower survival rate and without the cancer spreading. The study found that 46 percent of women who were classified as  high-risk clinically but low-risk genetically could skip chemo with just a slightly higher chance – 1.5 percent — of not surviving or their cancer having metastasized after five years. (Brooks, 8/24)

Public Health Roundup: Surprise Player In Scopes Contamination; How Poor Kids Are Treated At ERs

Meanwhile, a study finds that paid sick leave reduces cases of the flu because workers are more inclined to stay home when sick. And homeless advocates and public health officials are at odds over the Obama administration's plan for a smoking ban in public housing.

California Healthline: Gas Relief Drops, Often Added To Medical Scopes, May Pose Danger
A surprising ingredient — infant gas relief drops — may be contributing to the contamination of medical scopes nationwide and putting more patients at risk of infection, according to a small but provocative study. Researchers in Minnesota unexpectedly found cloudy, white fluid inside several colonoscopes and gastroscopes after they had been disinfected and deemed ready for use on the next patient. (Terhune, 8/25)

The Washington Post: How Emergency Rooms Treat Poorer Kids Differently
During emergency-room visits, children on public health insurance are less likely than children on private insurance to be admitted to the hospital. This is not because poorer children visit different kinds of hospitals or because poorer children are less sick when they visit the emergency room. As Princeton economists Diane Alexander and Janet Currie show in a recent paper released by the National Bureau of Economic Research, hospitals just seem to prefer children with private insurance. (Guo, 8/24)

The Wall Street Journal: Paid Sick Leave Reduces The Flu Rate ‘Significantly,’ Paper Says
Everyone knows staying home from work when you have the flu helps protect your co-workers from getting sick. Unfortunately, not everyone does it. A new National Bureau of Economic Research paper argues that one reason for that is access to paid sick leave. The paper by Stefan Pichler and Nicolas R. Ziebarth argues that the general flu rate “decreases significantly” when employees have access to paid time off due to illness. It also found that more people play hooky, or stay home when they aren’t actually contagious. (Raice, 8/24)

The Hill: Smoking Ban For Public Housing Sparks Backlash 
Homeless advocates and public health officials are squaring off over a controversial Obama administration proposal to ban smoking in government-assisted housing projects. The smoking ban has drawn praise from health officials who say it would spare non-smokers from the dangerous effects of secondhand smoke. But homeless advocates are enraged by the proposal, which they fear could force low-income residents who can’t kick the habit out of their homes. (Devaney, 8/25)


Pfizer Targets AstraZeneca's Antibiotics Portfolio With Latest Acquisition

In other pharmaceutical and marketplace news, the Food and Drug Administration rejects Amgen's petition for a new application for its hormonal imbalance therapy drug. And KQED reports on Silicon Valley's new focus on nootropics.

The Associated Press: Pfizer On Buying Spree With AstraZeneca Antibiotics Deal
Drugmaker Pfizer Inc. is continuing its shopping spree with its fourth acquisition since the April collapse of its planned $160 billion megadeal to buy rival Allergan PLC and move its headquarters, on paper, to Allergan's base in lower-tax Ireland. In its second deal this week, New York-based Pfizer said it's buying rights to Anglo-Swedish drugmaker AstraZeneca PLC's portfolio of approved and experimental antibiotic and antifungal pills, a move to boost Pfizer's business in one of its priority areas. (Johnson, 8/24)

The Wall Street Journal: FDA Rejects Amgen Hormonal-Imbalance Treatment
Amgen Inc. said Wednesday that government regulators have rejected its new drug application for its therapy for a hormonal imbalance common in patients on dialysis. ... Amgen said it expects to meet with the U.S. Food and Drug Administration to discuss the agency’s decision sometime later this year. The company said it was reviewing the government response but didn’t provide specifics. (Minaya, 8/24)

State Watch

Two Fla. Hospitals Opt Not To Bill Victims Of Pulse Nightclub Shooting

Orlando Health and Florida Hospital are forgiving about $5.5 million in related medical costs.

Orlando Sentinel: Orlando Health, Florida Hospital Won't Bill Pulse Shooting Victims 
Orlando Health and Florida Hospital will not bill survivors of the Pulse nightclub massacre for out-of-pocket medical expenses, officials announced Wednesday. Instead, the hospitals will write off an estimated $5.5 million or more in care...Its main hospital — Orlando Regional Medical Center — treated 44 of the more than 50 victims who needed immediate medical attention from the June 12 attack that killed 49 people. The nightclub is only a couple of blocks from the Level 1 trauma center. (Santich and Hayes, 8/24)

The Washington Post: Orlando Hospitals Say They Won’t Bill Survivors Of Pulse Nightclub Shooting
The Orlando hospitals that treated dozens of people injured in the Pulse nightclub shooting said Wednesday that they would not bill the survivors. One hospital said it would not bill for any treatment it provided Pulse victims, while Orlando Regional Medical Center, the hospital that treated most of the survivors, said it would seek payment from other resources such as insurance plans and a victims fund set up by city officials. Authorities there said they expect the “total unreimbursed costs” could top $5 million. (Berman, 8/24)

WMFE: Orlando Health Won't Bill Victims For Pulse Night Club Shooting
The hospital said it will bill insurance if patients have it, but it will not go after a patient for co-pays or deductibles. Rather, the hospital will seek federal and state money, including money from the OneOrlando fund and private fundraising accounts for victims. The hospital will also look for disability insurance, Florida’s crime victim compensation program, means-tested programs like Medicaid, as well as charity care provided by Orlando Health. (Aboraya, 8/24)

Cleveland Plain Dealer: Florida Hospitals Won't Bill Victims Of Pulse Nightclub Shooting
Two hospital systems in Orlando announced Wednesday they will not bill survivors of a shooting last June at a gay nightclub in which 49 people were killed. ... The hospital systems, Orlando Health and Florida Hospital, are forgiving about $5.5 million in medical costs. Bills will be sent to insurance companies for patients who were covered, but any uncovered costs will not be charged to the victims. (Pinckard, 8/25)

Three Mt. Sinai Hospitals To Pay $3M In Medicare, Medicaid Overpayments

In other state hospital news, there's a new program for Georgia's rural hospitals. Also, news outlets provide updates on the fiscal health of hospitals in Massachusetts and funding plans for Parkland Hospital in Dallas.

Modern Healthcare: Mount Sinai Overpayment Settlement Puts Health Systems On Notice 
Three hospitals within Mount Sinai Health System will pay nearly $3 million to settle a whistle-blower suit alleging they held onto Medicare and Medicaid overpayments beyond the 60-day repayment window, marking one of the first settlements over an issue that could affect health systems across the country.The New York City health system agreed on Wednesday to pay $2.95 million rather than go to trial over $844,000 in retained Medicaid overpayments, where they could have faced treble damages as well as $4.9 million in False Claims Act penalties for the 444 payments in question. (Teichert, 8/24)

Georgia Health News: Donation Program For Rural Hospitals Opens Door For Consulting Firms
State health officials say 48 rural hospitals are eligible to receive donations from individuals and corporations under a new Georgia program that will give tax credits to donors. The list of eligible hospitals, along with financial forms, were issued by the state Department of Community Health this week. The tax credit program, passed by the Legislature this year, has generated high interest within the hospital industry. At the same time, new attention has been focused on the creation of consulting services that aim to help rural hospitals market themselves and apply for the funds. (Miller, 8/24)

The Boston Globe: Mass. Hospitals In Decent Fiscal Health Despite Tough Conditions
Most Massachusetts hospitals were profitable last year, even as they faced pressures to control expenses and become more efficient in a fast-changing health care market. A report set to be issued Thursday by the state’s Center for Health Information and Analysis, or CHIA, showed that 80 percent of the state’s 65 hospitals ended 2015 with a net profit.Hospitals posted a median operating margin of 3 percent of revenue. Total profit margin, which includes investment income, was a median of 3.7 percent. Those results were similar to how hospitals have performed over the past few years. (McCluskey, 8/25)

Dallas Morning News: Parkland Hospital Board Passes $1.5 Billion Budget Amid Rising Costs, Falling Revenue 
The Parkland Memorial Hospital board of managers unanimously passed a $1.5 billion budget Wednesday for the coming year, in which officials project rising costs and falling revenue. The budget still contains a $38.8 million hole, largely due to the whopping $105 million in depreciation related to Parkland's new hospital. Even so, the public hospital projects to have $54 million in cash reserves that it needs for operations. (Martin, 8/24)

New Orleans Times-Picayune: Jefferson Picks 'Minimally Qualified' Operator For Health Clinics 
A "minimally qualified" applicant was chosen Wednesday (Aug. 24) by the Jefferson Parish Council to operate two publicly owned medical clinics. The award came three months after the council moved to end its lease with the current operator, Jefferson Community Health Centers, which then applied for the new lease but was deemed unqualified because of faulty paperwork. The council selected Access Health Louisiana for the leases at 1855 Ames Blvd. in Marrero and 11312 Jefferson Highway in River Ridge. (Nobles, 8/24)

State Highlights: Ind., Ohio Confront Overdoses From 'Amped-Up' Heroin; In N.Y., Few Homeless Shelter Workers Can Administer Narcan

Outlets report on health news from Indiana, Ohio, New York, Kansas, Virginia, Florida, Missouri, Georgia, Texas, Massachusetts, California and Michigan.

The New York Times: Few Homeless Shelter Workers Are Trained To Administer Heroin Antidote
Overdoses were the leading cause of death among homeless people in shelters during the last fiscal year, accounting for 30 percent of fatalities, according to an annual report by the city’s Department of Health and Mental Hygiene. Yet only a fraction of the 272 city shelters — about 18 percent — have staff members who have been trained by the Department of Homeless Services to administer the antidote, which is available as nasal spray or an injection. Slightly more than half of the 84 shelters for single adults, where overdoses occur more frequently, have trained the staff. (Jula, 8/24)

Kansas Health Institute: With Safety In Mind, Kansas Changes High School Football Practice Rules 
Players aren’t allowed to go all-out until the fifth practice. Once games start, full-contact practices are limited to an hour and a half, and contact isn’t allowed the day after games. The new rules — formed with help from the National Federation of State High School Associations Concussion Summit Task Force — are meant to reduce players’ head injuries and brain trauma that have parents increasingly asking whether football is right for their kids. (Marso, 8/25)

Richmond Times Dispatch: 4 Tropical Smoothie Cafe Customers Contracted Hepatitis A In Region; 23 In State
At least four people in the Richmond region and 23 across Virginia have contracted hepatitis A from strawberries served by Tropical Smoothie Cafe, according to the Virginia Department of Health. Frozen strawberries imported from Egypt, served to customers as recently as Aug. 9, are to blame in the nearly two dozen cases, health department officials said Wednesday. Though the strawberries were all pulled from the restaurants by Aug. 8 or Aug. 9, additional cases of hepatitis A might be confirmed in coming weeks because symptoms of the liver disease take as many as 50 days to appear, health department officials said. (Shulleeta, 8/24)

Health News Florida: Veterans' Nursing Homes Looking For Nurses
As Florida’s health care industry is growing, so too is the need for registered nurses and other medical personnel. The competition for qualified health care professionals is high which has one state agency banking on a nurse’s patriotism to attract new hires. “Florida Veterans – they served us - it’s an honor to now serve them.” That’s the opening line of a 30-second public service video produced by the Florida Department of Veterans’ Affairs. (O'Brien, 8/24)

St. Louis Public Radio: After 147 Years, Catholic Nuns Will Stop Running North St. Louis Nursing Home 
After nearly 150 years of ministering in St. Louis, the Little Sisters of the Poor will stop operating its residence for low-income elderly individuals in the city’s Old North neighborhood. The Catholic women religious order cites a lack of "sufficient vocations" to continue to staff their long-time St. Louis Residence facility at 3225 North Florissant Ave., which currently houses 88 people. It is run by eight Little Sisters and nearly 125 lay staff. (Lecci, 8/24)

The Atlanta Journal-Constitution: Why Doctors Who Sexually Abuse Patients Get Therapy And Return To Practice
Increasingly, private therapists, rather than regulators or police investigators, try to unearth the extent of a doctor’s transgressions, the Journal-Constitution found as part of a broad investigation of sexual misconduct by physicians. The newspaper’s full report is at The Journal-Constitution reviewed public disciplinary orders for 2,400 physicians accused of sexual misconduct with patients since 1999. The AJC found that, with rare exceptions, all of the 1,200 who are still licensed were ordered to undergo treatment, training, or both. (Hart, 8/24)

ProPublica: A Spike In Rates Of Pregnancy-Related Deaths In Texas Spurs Soul-Searching 
Last week, researchers studying maternal mortality in the U.S. reported an ominous trend: The rate of pregnancy-related deaths in Texas seemed to have doubled since 2010, making the Lone Star State one of the most dangerous places in the developed world to have a baby. Reproductive health advocates were quick to blame the legislature for slashing funding in 2011–12 to family-planning clinics that serve low-income women, calling the numbers a “tragedy” and “a national embarrassment.” Now a 15-member state task force has issued its own maternal mortality report, offering a new view of what might be going on. (Martin, 8/24)

Kaiser Health News: Giving Birth In Georgia Is Too Often A Deadly Event
Georgia enjoys its image as the Empire State of the South, a leader among its Deep South neighbors, the first to have an Olympic city and the first to send a native son to the White House. But for all of its firsts, the state is worst — or at least among the very worst — in a key measure: its rate of maternal mortality. (Anderson, 8/25)

The Boston Globe: Calls For More Oversight Of Medical Examiners Office
Top child-advocacy and pediatricians’ groups are calling on the governor to introduce more oversight of individual state medical examiners, saying the current system of giving each of them exclusive power to issue — or revise — homicide rulings undermines confidence in their findings. ... These proposals come in the wake of a Boston Globe article on Sunday that explored three retracted shaken-baby homicide rulings within 18 months, an unprecedented set of revisions that occurred after three medical examiners received reports from — and in some cases were actively lobbied by — defense attorneys before trial. (Wen, 8/25)

Los Angeles Times: Illegal Drugs Are Flowing Into California's Most Guarded Prisons — And Killing Death Row Inmates
The condemned inmates on California's death row are among the most closely monitored in the state. Death row’s 747 inmates spend most of their time locked down, isolated from the rest of the prison system under heavy guard with regular strip searches and checks every half-hour for signs of life. Still, six death row inmates died between 2010 and 2015 with detectable levels of methamphetamines, heroin metabolites or other drugs in their system, according to Marin County coroner records. (St. John, 8/24)

Health News Florida: How A Florida Teen Beat The Brain-Eating Amoeba
So many things had to go right for Gonzalez to get that gift of life. On a Friday, he had a bad headache. The next day at the theme parks, his parents decided this way more than just a migraine and took him to the emergency room at Florida Hospital for Children. Doctors convinced the family to do spinal tap to rule out meningitis – even though he didn’t have a stiff neck, the telltale symptom. That’s when Sheila Black, the lab coordinator, looked at the sample and saw white blood cells. But then she took a second, longer look. (Aboraya, 8/24)

Detroit Free Press: Water Chemistry Problems May Have Caused Flint Rashes
A months-long investigation that brought federal, state and local leaders to Flint to hunt for a cause of mysterious rashes and hair loss has not led to any definitive answers.Interviewers talked to 390 people with rashes and hair loss who had exposure to Flint municipal water after the switch back to Lake Huron...With the exception of lead, all metals and minerals the U.S. Environmental Protection Agency found in the water are common in most public water systems. None of the metals are likely to cause a rash or hair loss. (Shamus, 8/24)

St. Louis Post Dispatch: How Toxic Is Lead-Tainted Tap Water? 
For decades, St. Louis has battled a lead poisoning threat from paint in older homes. Now the discovery of lead in sinks and drinking fountains at some local schools raises questions about the safety of the tap water. Tap water from municipal sources is tested regularly and contains only trace amounts of lead. The toxic heavy metal can enter the water through corroding lead pipes and fixtures inside a building, especially if the water has not been turned on for several hours or days. (Bernhard, 8/25)

Weekend Reading

Longer Looks: Diagnosing Mental Illness, Epi-Pen Price Hikes and Zika

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The Atlantic: How Artificial Intelligence Could Help Diagnose Mental Disorders
People convey meaning by what they say as well as how they say it: Tone, word choice, and the length of a phrase are all crucial cues to understanding what’s going on in someone’s mind. When a psychiatrist or psychologist examines a person, they listen for these signals to get a sense of their wellbeing, drawing on past experience to guide their judgment. Researchers are now applying that same approach, with the help of machine learning, to diagnose people with mental disorders. (Joseph Frankel, 8/23)

Vox: EpiPen’s 400 Percent Price Hike Tells Us A Lot About What’s Wrong With American Health Care
The EpiPen was invented in the 1970s by a biomedical engineer, Sheldon Kaplan, who was searching for a way to treat allergic reactions quickly. What he came up with was the EpiPen we know today: a pen-like device that delivers a premeasured dose of the hormone epinephrine in emergency situations. The device is ubiquitous in our country, carried by those with asthma or life-threatening allergies. (Sarah Kliff, 8/23)

Pacific Standard: The Law Of Positive Attraction
Say you’re living with HIV in one of the 35 states with exposure laws — you can end up behind bars simply for having sex. That’s right: If you sleep with someone without telling them about your HIV status, that’s grounds, in many cases, for a prison sentence. What if you didn’t even transmit the virus? Doesn’t matter. The laws vary from state to state, and are modified from time to time, but, in most cases, you don’t even have to have sex, you just have to engage in behavior where there’s a risk of transmission. Just hope you’re not in one of 28 states that considers HIV exposure a felony: You could end up serving more than 20 years. (Whitney Mallett, 6/22)

The Atlantic: The Mystery Of Zika’s Path To The Placenta
Among the many mysteries that have vexed scientists about the ongoing Zika epidemic is the question of how, in pregnant women, the virus manages to cross the maternal-fetal barrier. A woman’s body is usually quite good at protecting her growing baby. There are biological blockades to prevent the transmission of viruses to a fetus through the bloodstream, by way of the placenta; the same path for the nutrients and oxygen that sustain a developing baby. The placental membrane is similarly adept at keeping harmful agents out. (Adrienne LaFrance, 8/18)

The Houston Chronicle: Parents Seek Hope For Mentally Ill Son
Warren [Muldrow] was not doing well in jail. If he was suicidal or homicidal, his attorney told the judge, Warren needed to get to a state hospital immediately. All agreed during the courtroom conference that he should be assessed immediately as a crisis case. Their decision put his fate, for the moment, in the hands of an outside evaluator who, they hoped, would make a quick determination. There was little time to lose. But few things ever went as planned for Warren, and county jails across Texas filled with the mentally ill spoke to how few options existed for meaningful, long-term care. (Emily Foxhall, 8/21)

Editorials And Opinions

Debate On EpiPens: 'Outrageous' Price Increase; FDA's Regulations To Blame

Editorials and commentators wrestle with the issue of spiraling cost of EpiPens, which are used to stop a deadly allergic reaction.

The New York Times: Another Drug Pricing Ripoff
The rapid increase in the price of the EpiPen, a device used to give an injection that can save people from deadly allergic reactions, has shocked consumers and lawmakers. Yet it is just one more outrageous instance of pharmaceutical companies raising prices for lifesaving medicines with no justification other than the desire to increase profits — and doing so knowing that government can do little about it. (8/25)

The Wall Street Journal: Anaphylactic Political Shock
In a statement, [Hillary Clinton] assailed the “outrageous” cost of EpiPen, an emergency treatment for allergic reactions known as anaphylaxis, and she demanded that drug maker Mylan “immediately reduce the price.” ... Competitors have been trying for years to challenge Mylan’s EpiPen franchise with low-cost alternatives—only to become entangled in the Food and Drug Administration’s regulatory afflatus. Approving a generic copy that is biologically equivalent to a branded drug is simple, but the FDA maintains no clear and consistent principles for generic drug-delivery devices like auto injectors or asthma inhalers. (8/24)

Miami Herald: Life, Death And Greed: EpiPen Price Increase Is An Outrage
The company’s monopoly in no way justifies the skyrocketing increase. If anything, having exclusive access to a life-saving drug should impose a special responsibility to ensure that it is available at a reasonable price to all those who need it. The company says it has given away about 700,000 EpiPens to schools since 2013 and provides coupons to cover the cost of co-payments for most consumers with commercial insurance. It also blames the problems caused by high-deductible plans that put its product out of reach for many families. But none of that explains the stiff increase in costs to the consumer. (8/24)

The Hill: Competition Is The Cure For EpiPen’s Price Hike 
In 2004 a pack of two EpiPens, life-saving products used to halt severe allergic reactions, cost $100. Now, two pens list for upwards of $600 — a 450 percent price increase for the same injector to deliver the same $1 dose of epinephrine it did 12 years ago. If you find this increase troubling, you are not alone. Earlier this week, Senator Chuck Grassley (R-Iowa) sent a letter to the CEO of Mylan Laboratories, EpiPen’s manufacturer, asking for information on its pricing strategy. Today, Senator Amy Klobuchar (D-Minn.) called Mylan’s pricing “outrageous” in a letter to the Federal Trade Commission.  (Paul Howard, 8/24)

Viewpoints: A Strategy To Lower Drug Prices; Guiliani's Health; Single-Payer Is Inevitable

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

Los Angeles Times: Here's How A President Clinton Could Force Down Drug Prices By Executive Action
Presidential candidate Hillary Clinton brought down the hammer on drug makers last week, promising to “take on” drug companies that charge Americans the highest prices in the world for drugs developed in part with government funds. ... That just raises the question: What could she do as president? And could she do it by herself, without congressional approval?The answer may well be yes. (Michael Hiltzik, 8/24)

The Washington Post: Is Rudy Giuliani Okay?
Unfortunately, Mr. Trump, 70, has taken the same nondisclosure stance on his health records as he has on his taxes, asserting there is nothing to hide while hiding everything. Ms. Clinton, by contrast, has released some test results, which, as far as they go, indicate good health. That hasn’t stopped Mr. Giuliani from trading in scurrilous and debunked theories about the Democratic candidate. Come to think of it, he should see a doctor. (8/25)

San Francisco Chronicle: Why A Single-Payer System Is Inevitable
The best argument for a single-payer health care plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans. Aetna’s decision follows similar moves by UnitedHealth Group, the nation’s largest health insurer, and by Humana, another one of the giants.All claim they’re not making enough money because too many people with serious health problems are using the Obamacare exchanges, and not enough healthy people are signing up. The problem isn’t Obamacare per se. It lies in the structure of private markets for health insurance, which creates powerful incentives to avoid sick people and attract healthy ones. Obamacare is just making this structural problem more obvious. (Robert Reich, 8/24)

Tampa Bay Times: Reveal Location Of Tampa Bay Zika Case
Gov. Rick Scott has worked hard to keep the spread of the Zika virus in the news and on Floridians' minds. He has visited affected areas, held roundtables with local health officials and bashed Congress for failing to approve funding to deal with the outbreak. And yet the governor and the Florida Department of Health consistently refuse to release basic information. Now Scott's omission du jour hits home: He won't say where in Pinellas County a locally transmitted case of Zika has been confirmed. A public health scare is no time to leave out the details. Scott needs to provide residents with basic information to ease their concerns, not withhold information and spread apprehension. (8/24)

Forbes: Judge Orders Medicare To Clarify When It Will Pay For Rehab And Skilled Nursing
Imagine your mom has a stroke. Once she is stabilized, she is sent to a skilled nursing facility for rehab. Then she goes home and gets some home health care and additional physical therapy. Medicare may pay, but for how long? For many years, that was decided by the “improvement standard.” In other words, as long as this care helped mom become more mobile or improve her speech, Medicare would pay at least some of the cost (up to a maximum of 100 days per spell of illness). But once she stopped getting better, Medicare would stop paying. To the surprise of many, the improvement standard was an urban myth. (Howard Gleckman, 8/24)

Des Moines Register: Branstad Remains Clueless About Medicaid Woes
Last year, Gov. Terry Branstad’s spokesman told The Des Moines Register the governor believed Obamacare “is unaffordable, unsustainable and creates too much uncertainty for Iowans. The implementation of this law has been flawed from the very beginning.” Oh, the irony. Iowans currently are mired in the disaster of the Medicaid privatization plan Branstad foisted upon the state this spring. (8/24)

Louisville (Ky.) Courier-Journal: Hospitals Should Help Fund Medicaid
The dire straits of Kentucky’s fiscal situation vis-à-vis its expanding Medicaid program has gotten much attention lately. It is fair to say that the rest of the Commonwealth’s budget was cut to make room for Medicaid’s anticipated needs. The growth in the portion of the budget for Medicaid benefits funded by General Fund tax revenue over the next two years is over half the amount of new General Fund revenue forecast to be collected over the same period. However, it is unfair either to claim this is necessary, or to blame this solely on Medicaid expansion. Like most states, Kentucky levies taxes and fees on health care providers to help fund Medicaid and relieve the burden on the rest of the state’s revenue sources. However, Kentucky’s funding from these sources, called restricted funds, has fallen off as a percentage of expenditures to roughly half of what it was a decade ago. (Justin Tapp, 8/24)

St. Louis Post-Dispatch: The Fight For Medicaid Expansion Reinvigorated
My 10 years of holding public office has taught me to expect surprises. However, I was completely surprised — actually shocked — to learn that a Cole County prosecutor had suggested I’d been the victim of the group of clergy protesters known as the “Medicaid 23.” When the protesters began their chants in the Senate gallery, I was on the floor filibustering a separate but similar attack on working people. The truth is, prosecution of the protesters was nothing more than the latest politically motivated smokescreen aimed at preventing what they, I and so many other Missourians are fighting for: Medicaid expansion across our state. (Jamilah Nasheed, 8/24)

Seattle Times: The Role Of Government In Fixing The Broken Mental-Health System
The U.S. House recently passed H.R. 2646 to make the federal government accountable, on an outcomes basis, for the $130 billion spent annually on mental-health treatment. Multiple mental-health organizations and media outlets, including The Seattle Times, support the bill, called the Helping Families in Mental Health Crisis Act. The U.S. Senate is expected to pass similar legislation. ... People with mental illnesses range from well-functioning individuals to those with severe disabilities. The role of government is to serve as a safety net and to help dysfunctional, impaired people who may do harm to themselves or others. (Roger Stark, 8/23)

The Hill: How A Last-Minute Visa Is Saving Lives And Salvaging Obamacare 
The genius in Beckers’ company’s innovation is that its practical applications extend far beyond analyzing blood flow. His team has created a new platform for patient evaluation, analysis and treatment based on artificial intelligence and deep learning, which could one day help treat brain damage, cancer and other major illnesses. It could also be used to detect and prevent possible future illness as the visualization, data aggregation and predictive capabilities improve daily. The bigger the database, the better the results. ... I can't help but wonder what would have happened if Fabien [Beckers] had been forced to leave the U.S. Other countries don't have the capital investment pool or willingness to invest in risky ventures. His efforts may never have been funded. (Gary Shapiro, 8/24)