KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Answering Your Questions On The 'Cadillac Tax'

The excise tax will be levied on health insurance plans costing more than $10,200 for an individual or $27,500 for a family. Any value over those thresholds will be taxed at 40 percent, and that's likely to affect consumers' benefits, share of health care costs or their coverage entirely. (9/2)

Political Cartoon: 'Mr. Brightside'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Mr. Brightside'" by Bill Thomas.

Here's today's health policy haiku:

LEGIONNAIRE'S IN SAN QUENTIN?

At this state prison
It's an outbreak -- not break out --
raising health alarms.

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

Marketplace

Health Care Co-Op Could Play Role In UAW Contract Negotiations

Interest by the United Auto Workers is reportedly in part the result of the success of a $61 billion fund started in 2010 that provides medical coverage for more than 750,000 retired auto workers.

The Wall Street Journal: UAW Pitches Health-Care Co-Op To Car Makers
The United Auto Workers union is pushing Detroit car makers to put all their employees under one health-care umbrella, creating a powerful purchasing group that could upend traditional health care markets. The union’s idea would create a joint purchasing group for the three largest U.S. auto makers that would cover factory and white-collar workers and union-affiliated retirees. The group could total nearly 1 million members, a scale it believes would have unprecedented leverage in negotiating directly with hospitals, drug companies and others. (Rogers and Wilde Mathews, 9/2)

Bloomberg: Bill Ford Says Health Care Co-op Possible In Union Negotiations
Ford Motor Co. Executive Chairman Bill Ford said the company is considering a health-care co-op, an issue the United Auto Workers union has raised in negotiations on a new contract. The UAW has turned its attention to a health-care pool based on the success of a $61 billion fund started in 2010 that provides medical coverage for more than 750,000 retired auto workers. The UAW Retiree Medical Benefits Trust has cut drug costs, added preventive care and restored benefits such as dental and vision while also increasing assets. (Naughton, 9/2)

Digital Stethoscope Gets FDA Nod, Clears Way For Easier Patient Info Sharing

Elsewhere, new smartphone apps let you book doctor house calls, and a closer look at the construction boom of cancer treatment centers.

Los Angeles Times: Stethoscope Meets Smartphone And The Heart Knows It's Right
Call it a winter-spring romance: The oldest tool in a doctor's kit -- a stethoscope -- meets the youngest -- a smartphone. Together, they make (and hear, see, analyze and record) heartbeats race. The Food and Drug Administration has cleared for the U.S. market a digital stethoscope, the Eko Core, that aims to bring auscultation -- the ancient medical practice of listening to a patient's heartbeat -- squarely into the 21st century. (Healy, 9/2)

The Kansas City Star: Bringing Back The House Call: Apps In Some Big Cities Let You Summon A Doctor
If you’re old enough, childhood memories include being able to get your family doctor to come to your house — even if pizza delivery didn’t exist yet in your town. Now, thanks to a new batch of smartphone apps, people under the weather in and around Los Angeles, San Francisco and New York can summon a doctor, sometimes faster than they can get a double pepperoni with extra cheese. (Hack, 9/2)

The Washington Post: A Cancer Building Boom, Fueled By Economics And An Aging Population
Had she faced breast cancer years ago, Gail Brown might have ended up traveling hours to one of the renowned cancer research hospitals in New York or Boston. But when the 68-year-old retiree received her diagnosis this spring, a $40 million, 70,000-square-foot cancer center was opening its doors on a wooded hilltop here. Leaders of the center, the Hartford HealthCare Cancer Institute, had formed a partnership with New York’s Memorial Sloan Kettering Cancer Center, part of an alliance aimed at bringing the most up-to-date cancer care to smaller communities. (Dennis, 9/2)

Health Law Issues And Implementation

Alaska's GOP Legislators Continue Suit Against Medicaid Expansion Despite Court Setbacks

The committee that brought a lawsuit against Gov. Bill Walker met but announced no changes in strategy. Alaska officials say they have approved 27 people for Medicaid since enrollment in the expansion program began Tuesday and more than 350 people have applied already.

Alaska Dispatch News: Alaska Lawmakers Meet On Medicaid Challenge But Don't Drop Lawsuit
The legislative committee that voted to sue Alaska Gov. Bill Walker over Medicaid expansion met Wednesday but took no action and offered no indication it would back away from its lawsuit -- even after two unfavorable rulings from state courts. The meeting, held on short notice and out of public view in an "executive session" in the Legislature’s Anchorage offices, was informational, with lawmakers hearing from their nonpartisan staff attorneys about legal questions surrounding Walker’s decision to expand the Medicaid health care program without legislative approval. (Herz, 9/2)

Alaska Dispatch News: State Approves 27 Alaskans For Benefits On First Day Of Medicaid Expansion
Twenty-seven Alaskans were approved for benefits under Medicaid expansion Tuesday, the first day of the broadened health care program, the state Department of Health and Social Services announced Wednesday. At least 252 people submitted paper applications Tuesday related to Medicaid expansion at Division of Public Assistance offices, said Sarana Schell, public information officer for the health department. Another 104 Alaskans submitted Medicaid applications online, though the state could not say whether they were taking advantage of the expanded program or were filing under the old rules, said Tammie Walker, acting chief of field services for the state's Division of Public Assistance. (Hanlon, 9/2)

Medicare

White House Urges HHS To Be 'More Aggressive' In Fighting Overpayments In Medicare, Medicaid

The message came in a letter from budget director Shaun Donovan. Meanwhile, in North Carolina, a whistleblower is alleging that a major health system fraudulently billed the government.

NPR/Center For Public Integrity: White House Takes Aim At Medicare And Medicaid Billing Errors
White House budget director Shaun Donovan called for a "more aggressive strategy" to thwart improper government payments to doctors, hospitals and insurance companies in a previously undisclosed letter to Health and Human Services Secretary Sylvia Mathews Burwell earlier this year. Government health care programs covering millions of Americans waste billions of tax dollars every year through these improper payments, Donovan said in the Feb. 26, 2015 letter. (Schulte, 9/3)

The Charlotte Observer: Lawsuit: Carolina Hospitals Cheated Medicare Out Of Millions
A newly unsealed lawsuit alleges that Carolinas Medical Center and N.C. Baptist Hospital have fraudulently obtained tens of millions of dollars from Medicare and Medicaid through an arrangement that artificially inflated their expenses. The federal suit, filed by Forsyth County whistleblower Joe Vincoli, contends that the two hospitals overstated their costs – and thereby extracted more money from Medicare – by using a company that they own to provide health benefits to their employees. (Alexander, 9/2)

Veterans' Health Care

VA Can't Track How Many Of 867,000 Pending Cases Are Active Or If Patients Are Alive, Inspector General Finds

With the Department of Veterans Affairs' open applications going back nearly 20 years, and with many records undated, the report estimates that a third of those who applied for health care are now dead. Meanwhile, in another hit to veterans seeking care, a torrential storm damaged the Phoenix VA hospital, forcing patients to be moved and appointments postponed.

The Associated Press: Watchdog: 900,000 Vets May Have Pending Health Care Requests
Nearly 900,000 military veterans have officially pending applications for health care from the Department of Veterans Affairs, the department's inspector general said Wednesday, but "serious" problems with enrollment data make it impossible to determine how many veterans were actively seeking VA health care. About one-third of the 867,000 veterans with pending applications are likely deceased, the report says, adding that "data limitations" prevent investigators from determining how many now-deceased veterans applied for health care benefits or when. The applications go back nearly two decades, and officials said some applicants may have died years ago. (Daly, 9/2)

CNN: 307,000 Veterans Died Awaiting Veterans Affairs Health Care, Report Says
Hundreds of thousands of veterans listed in the Department of Veterans Affairs enrollment system died before their applications for care were processed, according to a report issued Wednesday. The VA's inspector general found that out of about 800,000 records stalled in the agency's system for managing health care enrollment, there were more than 307,000 records that belonged to veterans who had died months or years in the past. (Devine, 9/2)

USA Today: Storm Damages Beleaguered Phoenix VA Hospital
Dozens of patients were moved, new-patient admissions were canceled and some medical procedures were postponed after a monsoon storm damaged the beleaguered Carl T. Hayden VA Medical Center, according to The Arizona Republic. Don Taylor, acting associate director of the hospital, told The Republic torrential rains Monday night, along with "almost hurricane-force winds," hammered the main building's west and south sides. Damage was also reported at the Phoenix Zoo, where several trees blew down. (9/3)

Campaign 2016

Hillary Clinton Targets 'Quiet Epidemic' Of Drug Abuse With $10B Plan

Funding for addiction treatment, prevention programs and criminal justice reforms are part of her proposal. "Plain and simple, drug and alcohol addiction is a disease, not a moral failing," the Democratic candidate wrote in an op-ed.

The New York Times: Hillary Clinton Proposes $10 Billion Plan To Combat Drug Epidemic
Hillary Rodham Clinton on Wednesday released plans for a $10 billion initiative to combat the escalating drug epidemic that she says has swept through rural America and has emerged as a regular concern among voters she has met in the early nominating states. “In state after state, this issue came up again and again — from so many people, from all walks of life, in small towns and big cities,” Mrs. Clinton wrote in an op-ed in The New Hampshire Union Leader. (Chozick, 9/2)

The Wall Street Journal's Washington Wire: Hillary Clinton Proposes $10 Billion Plan To Combat Drug Addiction
Hillary Clinton is proposing $10 billion in new federal grants to combat drug and alcohol addiction, the latest in a string of domestic policy proposals from the Democratic presidential contender. On the campaign trail, Mrs. Clinton regularly talks about how surprised she is to hear from voters in Iowa and New Hampshire about the challenge of combating heroin use, prescription drug abuse and other addictions. Her plan includes a new grant program for states to tackle the issue and increased funding for an existing grant program. (Meckler, 9/2)

The Washington Post: Hillary Clinton’s $10 Billion Plan For Treating Drug Addiction
The program, much of which would be funded by the federal government, would also help get a life-saving rescue drug into the hands of more emergency responders to improve the odds for overdose victims. The plan, announced in an op-ed in the Manchester, N.H., Union Leader newspaper, grew out of months of discussion of national drug addiction at Clinton campaign events in New Hampshire, Iowa and elsewhere. The topic comes up nearly every time Clinton engages voters in public, and she has made the scourge of drug addiction a part of her stump speech. (Gearan, 9/2)

CBS News: Hillary Clinton Unveils $10 Billion Plan To Combat Addiction
Clinton's plan sets five goals focused on prevention, treatment and recovery, and encourages developing programming to educate young people earlier, increasing investment in rehabilitation centers and better access to training for first responders using nalaxone and professionals who write prescriptions. (Fraser-Chanpong, 9/2)

Public Health And Education

PrEP Pill Keeps San Francisco Clients HIV-Free

Kaiser Permanente says not one of the 657 patients on a drug regimen meant to stop new cases of the disease contracted the virus. In the meantime, a study says needle exchanges in Washington, D.C., prevented 120 new cases of HIV.

The New York Times: Insurer Says Clients On Daily Pill Have Stayed H.I.V.-Free
Demonstrating that taking a daily pill to prevent H.I.V. infection can work in the real world, San Francisco’s largest private health insurer announced Wednesday that not one of its 657 clients receiving the drug had become infected over a period of more than two years. That outcome contradicted some critics’ predictions that so-called pre-exposure prophylaxis, or PrEP, would lead to less condom use and more H.I.V. infections. A study published in Clinical Infectious Diseases found that the San Franciscans on PrEP, almost all of whom were gay men, did use fewer condoms — and contracted several other venereal diseases as a result. But none got H.I.V. (McNeil Jr., 9/2)

USA Today: Study: Needle Exchange Policy Prevented HIV
Lifting a ban on spending city money on needle exchanges for intravenous drug users prevented 120 new cases of HIV in two years in Washington, according to a new study that researchers hope can help other communities deal with a surge in addicts shooting up. (Ungar, 9/3)

State Watch

States Wrestle With Shortages In The Mental Health Workforce

Access issues are particularly acute in rural areas and in states like Texas.

The Associated Press: Across Much Of US, A Serious Shortage Of Phychiatrists
It is an irony that troubles health care providers and policymakers nationwide: Even as public awareness of mental illness increases, a shortage of psychiatrists worsens. In vast swaths of America, patients face lengthy drives to reach the nearest psychiatrist, if they can even find one willing to see them. Some states are promoting wider use of long-distance telepsychiatry to fill the gaps in care. In Texas, which faces a severe shortage, lawmakers recently voted to pay the student loans of psychiatrists willing to work in underserved areas. A bill in Congress would forgive student loans for child psychiatrists. (9/2)

Kaiser Health News: Texas Strives To Lure Mental Health Providers To Rural Counties
In her third year of medical school, Karen Duong found herself on the other side of Texas. She had driven 12 hours north from where she grew up on the Gulf Coast to a panhandle town called Hereford. "Hereford is known for being the beef capital of the world,” she says, laughing. “There’s definitely more cows than people out there.” (Silverman, 9/3)

In other news, California is taking steps to curb misuse of psychiatric meds for children in foster care, and some New Jersey legislators are pressing the Christie administration on the state's number of psychiatric beds -

NPR: California Moves To Stop Misuse Of Psychiatric Meds In Foster Care
Children in foster care are prescribed antipsychotic drugs at double to quadruple the rate of that not in foster care, according to a Government Accountability Office report. Hundreds of children were found to be taking five or more psychotropic medications at a time, although there is no medical evidence to support such a drug regimen. Thousands of children were prescribed doses that exceeded FDA-approved guidelines. The report found monitoring programs for psychotropic drugs provided to foster children fell short of guidelines established by the American Academy of Child and Adolescent Psychiatry. (Korry, 9/2)

NJ Spotlight: Legislators Press Christie Administration On Need For More Psychiatric Beds
Democratic legislators want to know why the state Department of Health cancelled a request last winter for applications to expand the number of beds available for psychiatric patients. The lawmakers’ call for answers about the cancellation is driven by concerns of behavioral-health providers and hospital officials who say emergency departments are under a great deal of pressure to find beds for psychiatric patients. State officials said that they’ve received the request and are reviewing it. (Kitchenman, 9/2)

And in Kansas -

The Kansas Health Institute News Service: Proposed Hospital Transfer Rule Worries Nursing Home Administrators
A federal rule buried in a host of other proposed Medicare and Medicaid changes has nursing home administrators in Kansas — and other states — shaking their heads. Released in July, the rule would require nursing homes and other long-term care facilities to have residents examined by a doctor, physician’s assistant, nurse practitioner or clinical nurse specialist before they are transferred to a hospital. Failure to comply could cause a “deficiency” mark in the nursing home’s annual Centers for Medicare and Medicaid Services review. Such marks can lead to fines, withheld payments and downgrades in a facility’s publicly available CMS rating. (Marso, 9/2)

Consumer Advocates Press Ark. Governor To Reinstate People Who Lost Medicaid Coverage

More than 53,000 state residents have lost their coverage because they failed to provide proof of their incomes within a 10-day deadline. In other news, Pennsylvania officials finish up an overhaul of the state's Medicaid system, and the Cleveland Plain Dealer profiles the difficulties of a woman who finds a part-time job and then loses her Medicaid benefits and can't afford private insurance.

Arkansas Online: Governor Petitioned To Reinsure 53,000
A coalition of advocacy groups on Wednesday called for Gov. Asa Hutchinson to restore Medicaid coverage for more than 53,000 Arkansans who failed to provide proof of their incomes within a 10-day deadline. The Arkansas Citizens First Congress, a coalition of 54 advocacy groups and charitable organizations, delivered a petition to Hutchinson with 2,300 signatures asking him to restore coverage to those whose insurance was canceled for failing to meet the deadline. (Davis, 9/3)

Arkansas News: Groups Call On Hutchinson To Reinstate People Kicked Off Medicaid, Private Option
On Aug. 3, two days before he was scheduled to undergo surgery in Cleveland for a heart condition, Randy Dollar of Jacksonville was told by a pharmacist that his health-care coverage had been cancelled. “I almost walked out the door and came home to die,” he said. Dollar is among 59,000 Arkansans whose coverage under Medicaid programs has been terminated during a controversial re-verification process that was the subject of a rally at the state Capitol on Wednesday. ... Groups holding Wednesday’s rally said that despite some recent improvements, the Medicaid re-verification process remains deeply flawed. (Lyon, 9/2)

The Associated Press: Wolf Administration Wraps Up Overhaul Of Medicaid Benefits
The Wolf administration said Tuesday that it had completed the transfer of more than 1 million adult Medicaid enrollees into a single, new benefits package it had created as the program expands to record numbers under the 2010 federal health care law. The process that the Human Services Department finished included the dismantling of changes that Gov. Tom Wolf’s predecessor had sought to make to Medicaid coverage as part of Pennsylvania’s embrace of the Medicaid expansion. (Levy, 9/2)

Wider Coverage, But Higher Cost In Ohio Insurance Plans

Ohio has the third-highest number of enrollees in high-deductible plans, trade group America's Health Insurance Plans says. In Louisiana, the insurance department takes over Louisiana Health Cooperative after it's revealed that the insurer has only $180,000 to pay off unexpectedly high claims, if they come.

The Cleveland Plain Dealer: Ohio Flooded With High-Cost Health Insurance; Coverage Goes Up But Access Goes Down
Ohio has the third largest number of enrollees in high-deductible insurance in the country, behind only Illinois and Texas, according to a study by America's Health Insurance Plans, a national trade group. The plans are popular because they carry lower premiums and help more people get insurance coverage. And some experts argue they put discipline back into the marketplace by encouraging patients to comparison shop and think more carefully about when they access care. (Ross, 9/2)

The Advocate: State Takes Over Nonprofit Health Insurer
The Louisiana Department of Insurance has taken over Metairie-based Louisiana Health Cooperative Inc., a nonprofit health insurance company created with $66 million in federal loans. District Judge Donald Johnson issued an order Tuesday granting the department’s request to place the co-op into rehabilitation. The order allows Insurance Commissioner Jim Donelon to take possession and control of the failed insurer. The department’s regulators have been stationed at the co-op since July 29. (Griggs, 9/2)

Federal Judge Puts A Hold On La.'s Effort To Terminate Medicaid Contracts With Planned Parenthood

Meanwhile, bills have been advanced in the Wisconsin legislature that also target the reproductive health organization.

Bloomberg News: Louisiana Can't Yank Planned Parenthood's Medicaid Funds Yet
Louisiana's plan to yank Planned Parenthood's Medicaid contracts Wednesday was put on hold until Sept. 15 as a federal judge questioned the state's reasons for terminating them. Gov. Bobby Jindal, a Republican presidential candidate, vowed to take away the group's public funding after the organization was accused in a video campaign that purported to show its doctors discussing harvesting fetal tissue for research. (Hasselle and Calkins, 9/2)

The Associated Press: Judge To Decide If Planned Parenthood Stays In La. Medicaid
A federal judge on Wednesday questioned why Gov. Bobby Jindal's administration removed Planned Parenthood from Louisiana's Medicaid program if its clinics are competent to provide health care services. U.S. District Judge John deGravelles seemed skeptical about the justification that Jindal's health secretary, Kathy Kliebert, is using to terminate the Medicaid provider agreements Louisiana has with Planned Parenthood's clinics in New Orleans and Baton Rouge. (DeSlatte, 9/2)

Tribune Wire Reports: Republican Bills In Wisconsin Target Planned Parenthood Federal Funding
About $7.5 million in federal funding for Planned Parenthood in Wisconsin would be cut under two Republican-backed bills heard Wednesday by a state Assembly committee, measures that come as the Legislature also considers criminalizing research on aborted fetal tissue. Supporters defended the measures as reasonable steps to prevent taxpayer money going to a group that provides abortions. But opponents said halting the funding would adversely affect the women's health services, including cancer screenings and wellness checks, which Planned Parenthood also provides to about 60,000 men and women a year. (9/2)

And on Capitol Hill -

The Washington Post: Parade Of Planned Parenthood Hearings Begins Next Week
Congress will make its first public examination of Planned Parenthood next week, a day after lawmakers return from their long summer recess, following the release of a series of undercover videos airing frank conversations about the group's fetal tissue practices. The Sept. 9 hearing scheduled Wednesday by the House Judiciary Committee will be the first in a series titled "Planned Parenthood Exposed: Examining the Horrific Abortion Practices at the Nation's Largest Abortion Provider" -- making clear that the women's health care provider can expect withering attention from the committee's Republican majority. (DeBonis, 9/2)

San Quentin Prison Officials Still Searching For Source Of Legionnaires' Outbreak

More than 100 inmates of this state prison in California are sick, and the Los Angeles Times reports that an environmental consultant has been brought in to try to pinpoint the source of the disease.

Los Angeles Times: Legionnaires' Outbreak Grows, Keeping San Quentin Locked Down
An environmental consultant has been brought into the hunt for the source of Legionnaires' disease at San Quentin state prison. After six days of testing, officials still do not know what caused the outbreak that has left more than 100 inmates sick and the sprawling historic prison in near-lockdown. Showers and drinking water have been shut off since a prisoner was diagnosed with the severe illness Thursday. In addition, prison officials said they are consulting daily with the U.S. Centers for Disease Control and Prevention as well as the state health department. (St. John, 9/2)

The New York Times: San Quentin Prison Scrambles After Outbreak Of Legionnaires’ Disease
The thick walls of San Quentin State Prison contain thousands of criminals housed deep within a rambling complex on the edge of San Francisco Bay. But since last week, when the first of six prisoners tested positive for Legionnaires’ disease, those ramparts seem to have also turned the prison into a petri dish. An outbreak of the disease has reverberated from death row to solitary confinement, with 95 additional inmates reporting the infection’s pneumonialike symptoms in the last few days, though none of them have received an official diagnosis of Legionnaires’ disease. (Nir, 9/2)

Fla. Lawmaker Renews Push To Expand Prescribing Powers For Some Nurse Practitioners

Elsewhere, Illinois legislators override the governor's veto to allow Medicaid to pay for heroin addiction treatment, and the California right-to-die bill passed an early test vote Tuesday during a special legislative session.

News Service Of Florida: Senator Tries Again On Expanded Prescribing Powers
A Senate Republican on Tuesday proposed a wide-ranging health bill that includes allowing advanced-registered nurse practitioners to prescribe controlled substances. The bill (SB 210), filed by state Sen. Denise Grimsley, R-Sebring, could help renew a long-running lobbying battle in which doctors have opposed expanded drug-prescribing powers for advanced-registered nurse practitioners. (9/2)

NPR: Illinois House Leaders Override Governor's Veto On Heroin Addiction Bill
Illinois lawmakers set aside their bitter partisan bickering Wednesday to override Republican Gov. Bruce Rauner's partial veto of bill addressing the state's heroin crisis. Illinois has one of the highest rates of heroin overdose deaths in the country, and the Chicago area has led the nation in the number of emergency room visits related to heroin. And as we've recently reported, the heroin crisis has been growing worse as state funding for treatment programs has been cut. (Schaper, 9/2)

The San Jose Mercury News: Revived California Right-To-Die Bill Clears First Hurdle In Assembly Committee
Two weeks after Democrats revived controversial right-to-die legislation in a special legislative session on health care funding, the measure on Tuesday won bipartisan support and easily cleared an Assembly committee on a 10-3 vote. The powerful California Medical Association's opposition to an amendment floated by the lower house's Committee on Public Health and Developmental Services threatened to torpedo the measure's momentum. But in the end, the bill advanced without major revisions, even winning yes votes from Republicans for the first time. (Calefati, 9/2)

Texas Abortion Providers Ask For Supreme Court Review Of State Restrictions

Meanwhile, in Ohio, the abortion rate dropped more than 8 percent between 2013 and 2014.

The Texas Tribune: Abortion Providers Ask SCOTUS to Review Restrictions
Texas abortion providers on Wednesday asked the U.S. Supreme Court to take up their legal challenge to two provisions of the state's strict abortion law. After losing at the appellate level, a coalition of abortion providers is asking the high court for a reprieve from restrictions passed by the Texas Legislature in 2013. Those rules will require some abortion facilities to retrofit their clinics to meet the same standards as ambulatory surgical centers, from minimum sizes for rooms and doorways to pipelines for anesthesia and other infrastructure. (Ura, 9/2)

The Cleveland Plain Dealer: Abortion Total For 2014 Was Ohio's Lowest In Nearly 4 Decades
Abortion in Ohio dropped 8.7 percent from 2013 to 2014, with the state registering the lowest number of abortions for one year since it began tracking the statistics in the '70s, according to data from the Ohio Department of Health. Overall, there were 21,186 induced pregnancy terminations in 2014. That is a decline from 23,216 abortions the previous year. (Higgs, 9/2)

State Highlights: Calif. Deal With Key Unions Advances Idea Of Paying Forward For Retiree Health Benefits; Ohio High Court To Hear Medical Records Case

Health care stories are reported from California, Ohio, Georgia, Pennsylvania, New Jersey, Delaware, North Carolina, Minnesota, California and Nebraska.

The Sacramento Bee: Deal On State Retiree Health Care Benefits May Set Precedent
Gov. Jerry Brown’s administration has reached a tentative deal with a key employee union that would require state engineers to contribute toward their retirement health care benefits, likely establishing a template that will be applied to other state employee unions to help reduce a growing financial liability. Under the three-year agreement, which still must be ratified by the union’s members and the Democratic-dominated Legislature, the Professional Engineers in California Government in mid-2017 would have to begin paying one-half of 1 percent of their pre-tax salaries into a fund to chip away at the fiscal millstone. (Cadelago and Ortiz, 9/2)

Georgia Health News: Northside, Gwinnett Medical Talk Giant Merger
Up until now, Northside Hospital has stayed relatively quiet in the almost frantic rush by metro Atlanta hospital systems to seek mergers or acquisitions. But Northside is now jumping into the fray, with a Wednesday announcement that it and Gwinnett Medical Center will begin talks to merge operations.(Miller, 9/2)

The Columbus Post-Dispatch: Ohio Supreme Court Hears Case About Medical Records And Patient Rights
If the Ohio Supreme Court upholds a decision that exempted some of a patient’s medical records from his daughters’ request, hospitals could hide critical details about the care of those who are harmed or die there, say the plaintiffs of a case heard this morning. The lawsuit arose in Canton, where Howard E. Griffith died in 2012 at Aultman Hospital. Griffith’s heart monitor somehow was ripped off and he spent 40 minutes alone before he was found unresponsive, according to court records. He died two days later in intensive care. (Crane, 9/2)

The Philadelphia Inquirer: U.S. Internal Medicine Docs: Mass Deportation Would Be Bad For Country's Health
While critics have appropriately pushed back citing the high cost, ineffectiveness, and impracticality of mass deportation, there is another consequence that has been largely overlooked, which is the grave impact that kicking millions of people out of the country would have on the health of those directly affected, on their families, on their communities, and on the overall health of our country. There are an estimated 160,000 undocumented persons in Pennsylvania and another 550,000 in New Jersey (2010 estimates) whose health could be directly placed at risk under a mass deportation policy. It is this concern about the health consequences of deportation that led the American College of Physicians, my employer, to urge physicians to speak out, individually and collectively, against mass deportation, reaffirming a position that it first adopted in 2011. ACP, based in Philadelphia, is the nations’ largest physician specialty society and second largest physician membership organization, representing 143,000 internal medicine physician and medical student members. (Doherty, 9/2)

MPR News: Medical Marijuana Company Delays 2 Clinic Openings
A Minnesota medical cannabis manufacturer won't open its third dispensary site until patient demand catches up with supply. Minnesota Medical Solutions was set to open a Moorhead location this fall, but CEO Kyle Kingsley said it will have to wait until next spring or summer. (Feshir, 9/2)

The Associated Press: School Drug Counselors Charged In $46M Fraud Scheme
Some were students who had tried drugs or alcohol, but didn't have substance abuse problems. Others were young addicts in need of help. Neither group necessarily fared well under counseling programs run by a Long Beach company for Los Angeles County schools, federal prosecutors said Wednesday. Dabblers were dubbed abusers, and hard-core users didn't always get the care they needed. (Melley, 9/2)

The Associated Press: Nebraska Nursing Home For Native Americans To Open Next Year
A long-awaited Nebraska nursing home on the border with South Dakota's Pine Ridge Indian Reservation will begin accepting Native American residents early next year to ease a severe care shortage in one of the nation's poorest regions, a project official said Wednesday. The facility is under construction on a 600-acre patch of tribal land in Whiteclay, a tiny Nebraska village on the South Dakota border that is known for selling millions of cans of beer each year to residents of the neighboring dry reservation. (Schulte, 9/2)

Los Angeles Times: Stories Of Mexican Mothers Having Babies In U.S. Are Complex, Texas Doctors Say
The mother arrived at the hospital last week in need of an emergency caesarean section, saying she had crossed the border to run an errand in town, not so her baby would be born an American citizen. She assured the doctor that she arrived at the hospital just "because [she] was here." Dr. Rolando Guerrero listened skeptically. "They always have a story," he said after delivering her 8-pound boy, Dylan. (Hennessy-Fiske, 9/3)

Weekend Reading

Longer Looks: A Cancer Diagnosis; Oliver Sacks; Replicating Studies; The Return Of IUDs

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

The New York Times: Was It Cancer? Getting The Diagnosis
I often wondered what it would be like to have a cancer growing inside your body. To suddenly discover you are carrying something that is eating you away, growing in an ugly, consuming mass in or around your bones or organs. To be blithely stepping through life, unaware that your insides are betraying you. I didn’t expect to find out, though, at least not for decades. (Julia Baird, 9/2)

Vox: Why Oliver Sacks Was So Remarkable, In 6 Quotes
When people die, there's a tendency to reduce them to something less than they were, to impose the neat arc of narrative on their otherwise messy and complex existence. In the case of Oliver Sacks, the author and neurologist who died Sunday, this would be a tragedy. If you've ever had the pleasure of reading anything he's written, you'll immediately understand why. (Julia Belluz, 8/31)

The New York Times: Oliver Sacks: Diverse Elements In Harmony
In person, what was striking about Dr. Sacks was his enthusiasm about whatever idea or object had caught his attention. It could be contagious to those around him and probably accounted in large part for his ability to bring sometimes daunting scientific material to a wide general audience. (Erica Goode, 8/31)

The Atlantic: How Reliable Are Psychology Studies?
No one is entirely clear on how Brian Nosek pulled it off, including Nosek himself. Over the last three years, the psychologist from the University of Virginia persuaded some 270 of his peers to channel their free time into repeating 100 published psychological experiments to see if they could get the same results a second time around. There would be no glory, no empirical eurekas, no breaking of fresh ground. Instead, this initiative—the Reproducibility Project—would be the first big systematic attempt to answer questions that have been vexing psychologists for years, if not decades. What proportion of results in their field are reliable? (Ed Young, 8/27)

Aeon: Fat But Fit?
At the intersection of physical and mental health, influenced by a heady mix of public health, sociology, economics and culture, the increase in average weight through the 21st century is a topic of passionate debate. The crux of the argument usually comes down to one fundamental question: is it possible to be fit and fat? We know that normal weight is by no means a guarantee of wellbeing, but is excess fat an absolute sign of poor health? (Caroline Weinberg, 8/27)

Pacific-Standard: Five Studies: Why IUDs Are Poised To Become The Future Of Birth Control
After decades out of favor, the intrauterine device is making a comeback. This small, T-shaped form of birth control, which is placed in a woman’s uterus and prevents pregnancy for between three and 10 years, has carried a stigma in the United States ever since the 1970s, when one notoriously flawed model, the Dalkon Shield, caused septic miscarriages and infertility in thousands of American women. But now, health-care providers are trumpeting the safety—and efficacy—of the models currently on the market (Nora Caplan-Bricker, 9/2)

Editorials And Opinions

Viewpoints: Concern About Firms' Move To Self-Insurance; An Ice-Bucket Challenge Success?

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

The Wall Street Journal: Remaking Companies For ObamaCare
Most of the 275 million Americans with health benefits probably see the logo on the corner of their insurance card and think that’s who has them covered. But for almost 100 million of them—the majority of Americans who get coverage through work—the true insurer is noted somewhere else: on their business card. It’s called self-insurance, and the Obama administration seems interested in curtailing the practice to shore up the Affordable Care Act’s health-insurance exchanges. (Mike Ferguson, 9/2)

Alaska Dispatch News: Alaska GOP Leaders Should Get The Message, Drop Medicaid Suit
One of the signs of real leadership is the ability to change course when it becomes clear a mistake has been made. One would hope, now that Judge Frank Pfiffner has been affirmed by the Alaska Supreme Court, that rather than wasting hundreds of thousands more of taxpayer’s dollars, in a time of budgetary crisis, the Legislative Council would drop its ill-considered litigation against Medicaid expansion. After reading the rejection grounds articulated in Pfiffner’s opinion, any litigant would hesitate before proceeding further. And it’s not like Pfiffner, appointed by Gov. Sean Parnell, is some kind of liberal. (John Havelock, 9/2)

Modern Healthcare: Texas Follows Florida Playbook In Seeking Medicaid Funding Extension Without Expansion
The governor of Texas was angry about a health plan leader's demand that he expand Medicaid to low-income, uninsured adults under the Affordable Care Act because he hates Obamacare. But behind the scenes, he and his aides were trying to convince the Obama administration to keep sending Texas billions of dollars in supplemental Medicaid funding to finance care for low-income, uninsured Texans—while continuing to insist he didn't want or need a Medicaid expansion that would extend coverage to more than 1 million Texans. If that sounds like a contradiction, welcome to the continuing political battle over the ACA and Medicaid expansion that has hospitals caught squarely in the middle. (Harris Meyer, 9/2)

The New York Times' The Upshot: Eight Things To Watch For In Donald Trump’s Tax Plan
Donald Trump is expected to release a tax plan in the next few weeks. What will it say? ... First, the good news for anti-tax conservatives: He has identified three areas in which he wants to cut taxes. ... This promise of a tax cut fits with Mr. Trump’s more unconstrained view of fiscal policy. While other Republicans (and many Democrats) warn about the long-term fiscal gap, he insists that cuts in Social Security, Medicare and Medicaid are unnecessary. “I’m going to make us so rich you don’t have to do those things,” he said in April. (Josh Barro, 9/2)

New Hampshire Union Leader: How We Can Win The Fight Against Substance Abuse
On my first trip to New Hampshire this spring, a retired doctor spoke up. ... He said his biggest worry was the rising tide of heroin addiction in the state, following a wave of prescription drug abuse. To be candid, I didn’t expect what came next. In state after state, this issue came up again and again — from so many people, from all walks of life, in small towns and big cities. ... This is not new. We’re not just now “discovering” this problem. But we should be saying enough is enough. It’s time we recognize as a nation that for too long, we have had a quiet epidemic on our hands. Plain and simple, drug and alcohol addiction is a disease, not a moral failing — and we must treat it as such. (Hillary Clinton, 9/1)

The New York Times: Payday For Ice Bucket Challenge’s Mocked Slacktivists
When Americans were giddily drenching themselves with ice water during the “ice bucket challenge” a year ago, the cognoscenti rolled their eyes. The aim of the ice bucket challenge was to raise money to combat A.L.S., also known as Lou Gehrig’s disease, a neurodegenerative ailment that affects some 15,000 Americans and usually leads to death within five years. But commentators scoffed: One on Time.com declared it “problematic in almost every way.” Critics sniped that the challenge wasted water and cannibalized contributions to better causes that affect more people. ... But now we have evidence that the ice bucket challenge may have worked. (Nicholas Kristof, 9/3)

Health Affairs: Planned Parenthood, Community Health Centers, And Women’s Health: Getting The Facts Right
The current Planned Parenthood fight, one of the most disturbing battles over women’s health in recent years, has been riddled with inaccuracies. A particularly damaging one is the assertion that the nation’s community health centers could pick up the slack if Planned Parenthood is defunded. I have worked with community health centers for nearly 40 years, and no one believes more strongly than I do in their ability to transform the primary health care landscape in medically underserved low-income communities. But a claim that community health centers readily can absorb the loss of Planned Parenthood clinics amounts to a gross misrepresentation of what even the best community health centers in the country would be able to do were Planned Parenthood to lose over 40 percent of its operating revenues overnight as the result of a ban on federal funding. (Sara Rosenbaum, 9/2)

Health Affairs: How PAs Factor Into Improved CMS Patient Satisfaction Scores
Today patient satisfaction is being dissected and analyzed many different ways by physician offices, hospitals, and Accountable Care Organizations (ACOs), driven largely by the Centers for Medicare and Medicaid Services (CMS) and a policy to tie reimbursement to patient perceptions and compliance with clinical performance guidelines. My question is this: Where are PAs, who are on the front lines of patient care, in this discussion and effort? My concern is that our profession is often overlooked by health leaders in patient satisfaction surveys. Yet we are major contributors to efforts to improve satisfaction goals. (Dawn Morton-Rias, 9/2)

JAMA Surgery: Raising The Bar For Failure To Rescue
Failure to rescue (FTR), the death rate among patients with postoperative complications, is an emerging surgical quality metric that has received increased focus in the last several years. Medicare has begun publicly reporting FTR on Hospital Compare, and the National Quality Forum has endorsed 3 separate FTR measures. Despite this great promise and rapid adoption, considerably less attention has been paid to the way in which FTR is measured and what the measurement of FTR is intended to achieve. Despite the surge in interest within the surgical community in the last several years, current FTR measures have remained largely unchanged. (Elliot Wakeam and Joseph A. Hyder, 9/2)