KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Kaiser Health News Original Stories

Farm Contractors Balk At Obamacare Requirements

The federal health law is putting farmers in a tough spot. Many contractors supplying workers have to offer health coverage. Insurance is costly, and contractors worry about immigration fallout. (April Dembosky, KQED, 2/11)

Political Cartoon: 'One And The Same'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'One And The Same'" by Dan Piraro.

Here's today's health policy haiku:

ANOTHER FIGHT IN THE BATTLE AGAINST ZIKA

A mosquito’s bite
Could add fuel to battle
Over abortion.

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.

Health Law Issues And Implementation

New Ky. Governor's Efforts On Health Care Galvanizing ACA Supporters And Opponents

Gov. Matt Bevin has become a hero to conservative Republicans opposed to the federal health law, while Obamacare supporters are concerned that his actions could hurt the 2 million people who have gained coverage in the state. In other news, a look at how the health law is affecting farm contractors, and Maryland reports its enrollment numbers.

The Fiscal Times: New Governor Moves Quickly To Dismantle Obamacare In Kentucky
Tea party Republican Matt Bevin had to tone down his anti-Obamacare rhetoric in order to win election as governor of Kentucky last November. Since then, there has been intense speculation over what Bevin would do to make good on his campaign promise to phase out Kynect, Kentucky’s state-run health insurance exchange .... Bevin is a hero among conservative Republicans who have been trying for years in Washington to either dismantle or seriously weaken the ACA, the signature health care initiative of President Obama. However, critics and healthcare advocates warn that Bevin’s move will create chaos and confusion for more than two million Kentuckians who currently are enrolled in private health insurance policies or Medicaid through Kynect. (Pianin, 2/10)

Kaiser Health News: Farm Contractors Balk At Obamacare Requirements
Obamacare is putting the agricultural industry in a tizzy. Many contractors who provide farm labor and must now offer workers health insurance are complaining loudly about the cost in their already low-margin business. Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore. About half of the farm labor workforce in the U.S. is undocumented. (Dembosky, 2/11)

The Baltimore Sun: State Health Insurance Enrollment Exceeds Goal
More than 162,000 Marylanders signed up for insurance under the Affordable Care Act, a 33 percent jump from last year that surpassed a state goal of 150,000 new people on the health insurance rolls. Officials with the Maryland Health Benefit Exchange, which oversees the state's enrollment efforts, released Tuesday the final numbers for this year's three-month enrollment period, which ended Feb. 5. Consumers had an extra five days to get insurance this year because of the January snowstorm that crippled the region. (McDaniels, 2/10)

Kansas House Rejects Debate On Medicaid Expansion

In a procedural move, the Kansas House denied efforts by expansion supporters to add the program during a debate on the budget. News outlets also report on Medicaid expansion debates in New Hampshire and Nebraska.

Topeka (Kan.) Capital-Journal: House Blocks Debate On Medicaid Expansion On Procedural Grounds
The House rejected an attempt Wednesday to force a debate over Medicaid expansion amid work on the state budget. Representatives voted 85-37 to block a Medicaid expansion package on procedural grounds. ... Last year, the House Vision 2020 Committee put forward a Medicaid expansion package, though it wasn’t debated on the House floor. It isn’t entirely clear House leadership would have enough votes to stop expansion from passing the chamber if it was brought up for a vote. Before the 2016 session, House Speaker Ray Merrick, R-Stilwell, also took three Republicans off the House Health and Human Services Committee. All three of the lawmakers are supporters of expansion. (Shorman, 2/10)

KCUR (Kansas City Public Radio): Medicaid Expansion Votes Denied In Both Kansas Chambers
House members were denied a vote on Medicaid expansion on procedural grounds in a floor debate Wednesday that mirrored one the Senate had a day earlier. Rep. Jim Ward, a Democrat from Wichita, tried to attach the amendment to enact expansion during the beginning of an hours-long debate on the state budget. ... He was stymied by a House rule that requires offsetting spending cuts for any amendments that add costs to the budget. Ward disagreed strongly when the rule was invoked. Under the ACA, Medicaid expansion is fully federally funded this year, but the states must kick in 5 percent next year. (Marso, 2/10)

The Associated Press: Republicans Block Kansas House Debate On Medicaid Expansion
The vote Wednesday in the GOP-dominated chamber was 85-37 against debating a proposal from Democratic Rep. Jim Ward of Wichita to expand for three years the health program for the poor, a move encouraged by President Barack Obama's health care law. The Kansas Medicaid program provides coverage for 362,000 poor and disabled Kansans, and Ward's proposal would have provided coverage for another 160,000 people. ... The Kansas Hospital Association and many advocates for the poor and disabled are pushing for an expansion of the Medicaid program. The 2010 federal health care law encouraged states to expand their Medicaid programs by promising that the federal government would pick up almost all of the costs. ... Republican Gov. Sam Brownback and GOP legislative leaders have argued that the federal government can't be trusted to keep its funding promises because of its own budget problems. Opponents also believe expanding Medicaid would be far more expensive for Kansas than supporters of the idea say. (2/10)

Concord (N.H) Monitor: House Gets Closer To Reauthorizing Medicaid Expansion
The Republican-controlled House gave initial approval to a bill that reauthorizes the state’s Medicaid expansion program for two more years. “This is the right thing to do for New Hampshire,” said the bill’s sponsor, Rep. Joe Lachance, a Manchester Republican. “The program is good for our residents, it’s good for our business, why wouldn’t we support this?” The House voted 207-136 in favor of the bill. The 400-member chamber has long been viewed the biggest obstacle for Medicaid expansion, and its initial endorsement Wednesday signals that the proposal may face smooth sailing ahead. (Morris, 2/10)

New Hampshire Union Leader: House Preliminarily Approves Two-Year Extension For Medicaid Expansion
The House made some significant changes to a bill that would extend Medicaid expansion for two more years. The House voted 207-136 to preliminarily approve House Bill 1696, which will have to return to the House for a final vote after the Finance Committee reviews the bill. The House voted down several amendments aimed at scuttling the bill before approving changes to require a person on the program be a state resident and participants would not open a person to a federal background check. (Rayno, 2/10)

The Associated Press: New Nebraska Medicaid Bill Reopens Old Divide In Hearing
The newest attempt to expand health care coverage with Medicaid dollars reopened an old divide Wednesday before a Nebraska legislative committee. A coalition of doctors, hospitals, local governments and uninsured residents urged lawmakers to advance the bill. Conservative groups and members of Gov. Pete Ricketts' administration argued before the Health and Human Services Committee that the proposal is unsustainable. (Schulte, 2/11)

Marketplace

Insurers, Hit Hard By ACA Loses, Eye 2016 Profits As Pivotal To Staying In The Exchanges

Humana is the latest to say it has experienced loses from plans under the health law. “If 2016 is like 2015, we’ll have a real problem, because carriers could just start pulling out,” said one analyst.

The Wall Street Journal: Insurers Under Pressure To Improve Margins On Health Plans
After most health insurers racked up financial losses on Affordable Care Act plans in 2014, many companies’ results for last year worsened, creating heavy pressure to improve performance this year. An analysis of filings by not-for-profit Blue Cross and Blue Shield insurers ... shows the challenge facing the industry .... They paid out more for health care in the first three quarters of 2015 than they took in from premiums on their individual plans. On Wednesday, Humana Inc. became the latest of the big publicly traded companies to flag problems, saying its losses on individual plans deepened last year. (Wilde Mathews, 2/10)

The Wall Street Journal: Humana Profit Falls, But Guidance Comes In Above Views
Humana Inc., which in July agreed to be acquired by rival Aetna Inc., said profit fell 30% in the fourth quarter as it set aside a reserve to account for losses expected on its 2016 Affordable Care Act business, but the firm gave guidance for the year sharply above Wall Street expectations. “Humana faced challenges across a number of fronts in 2015,” said Chief Financial Officer Brian Kane. But he said strength in its clinical model and administrative cost discipline, along with targeted pricing, helped position the company for “meaningful margin improvement” in its core individual Medicare Advantage business for the year. (Steele, 2/10)

Unexpected Health Costs Add To Challenge Of Recovering From Medical Care

The Associated Press reports that nearly a third of insured Americans who have financial problems tied to medical bills faced charges that their insurance would not cover. In other news, The Wall Street Journal reports on a counter-intuitive finding that, in retirement, the healthier a person is, they more they will spend on health care.

The Associated Press: Surprise Insurance Fees Often Follow Medical Emergencies
Recovering from a medical procedure is always a challenge, but getting hit with unexpected insurance fees can add financial hardship to the process. As health insurance plans become increasingly complicated, more patients are facing unexpected fees when they step outside their plan's coverage network. In many cases, patients don't realize they've received out-of-network care until they're slapped with a bill for hundreds or thousands of dollars. (2/10)

The Wall Street Journal: Healthy? You’ll Spend More On Health Care In Retirement
The healthier you are, the more money you need to save for health care in retirement. That’s the counterintuitive finding of new research by the Empower Institute, which is sponsored by Empower Retirement, a division of Great-West Financial that administers $440 billion in retirement plans. “Excellent health, ironically, can actually raise an individual’s lifetime health spending” simply because healthier people can generally expect to live longer, says the report, released Wednesday. (Tergesen, 2/10)

Pharmaceuticals

Burwell Says Administration Is Pursuing 'Every Option' To Address High Prescription Drug Costs

In other news, drug maker Mylan reaches $7.2 billion deal to buy the Swedish company, Meda, which has a portfolio of specialty generic and over-the-counter products. With the purchase, Mylan will gain access to new markets.

Modern Healthcare: Burwell Says Administration Is Doubling Down On Drug Price, Opioid Battles
HHS Secretary Silvia Mathews Burwell told lawmakers Wednesday the administration is "pursuing every administrative option" for addressing high prescription drug prices, starting with a few provisions in President Barack Obama's fiscal 2017 budget. Sen. Jim McDermott (D-Wash.) said he supports the budget's call for allowing the HHS secretary to negotiate with pharmaceutical companies on prices for biologics and particularly expensive drugs. (Muchmore, 2/10)

The Wall Street Journal: Mylan Reaches $7.2 Billion Deal For Sweden’s Meda
Mylan NV said Wednesday that it has agreed to buy Swedish pharmaceutical company Meda AB for $7.2 billion in cash and stock, while the drug maker also reported slower-than-expected growth in its fourth quarter. Mylan said the deal to buy Meda will build on its portfolio of specialty generic and over-the-counter products. The acquisition will also give Mylan access to new markets like China, Russia and the Middle East. (Dulaney, 2/10)

The Associated Press: Mylan To Buy Sweden’s Meda AB For $7.2 Billion
Drugmaker Mylan says it will buy Meda AB of Sweden for $7.2 billion in cash and stock, and says the move will help it enter new markets. Mylan valued the deal at $9.9 billion including Meda’s debt. It said Wednesday Meda’s board and largest shareholders support the sale. Meda says about 60 percent of its sales come from prescription drugs. Key products include drugs that treat respiratory conditions, skin ailments, and pain and inflammation. (2/10)

Women’s Health

Bill Defunding Planned Parenthood In Ohio Sent To Kasich

The governor and presidential candidate is expected to sign the legislation, which effectively cuts $1.3 million annually used by Planned Parenthood clinics for HIV testing, pre-natal care and other services. Meanwhile, media outlets offer coverage of Planned Parenthood and abortion news in Louisiana, Texas, Colorado and other states.

The Washington Post: Kasich Plans To Sign Ohio Bill Slashing Grants To Planned Parenthood
The Ohio legislature moved Wednesday to cut off $1.3 million in public health grants to Planned Parenthood in a closely watched vote that could have repercussions for the surging presidential campaign of Gov. John Kasich (R). The bill, which cleared the Senate last month and passed the House on Wednesday, prohibits the Ohio Department of Health from giving state or federal grants to organizations that conduct or “promote” abortions. Kasich, who placed second in the Republican primary in New Hampshire on Tuesday, has said he would sign the bill. (Somashekhar, 2/10)

Reuters: Ohio House Passes Bill To Deny Funds To Planned Parenthood
House Bill 294, which passed 59 to 32, blocks women's health providers that also provide abortions, or groups that refer patients to those providers, from receiving funds from a variety of state and federal grants. Planned Parenthood said the bill would hinder lower-income women's access to testing for sexually transmitted diseases, HIV tests and well-baby programs. According to its website, Planned Parenthood has 20 clinics in Ohio. Two provide abortions and all provide abortion referral. (Palmer, 2/10)

The Associated Press: Ohio Bill To Strip Planned Parenthood Funds Heads To Kasich
Planned Parenthood is not named in the legislation. But the bill's backers have acknowledged the organization will be the most affected. They want the money to go to health centers and other providers that do not perform abortions. Stephanie Ranade Krider, executive director of Ohio Right to Life, called the passage a victory for the anti-abortion movement. "For a state like Ohio — it's a purple state — to be able to pass something like defunding Planned Parenthood, I think that gives hope to other states." (2/10)

The Associated Press: Several States Seek To Block 2nd Trimester Abortion Method
Abortion opponents in Mississippi, West Virginia and several other states are filing bills to ban an abortion procedure commonly used in the second trimester that opponents describe as dismembering a fetus. Courts have already blocked similar laws that Kansas and Oklahoma enacted in 2015. The New York-based Center for Reproductive Rights, which represents abortion providers in legal fights, says banning the dilation and evacuation method of abortion — commonly called "D&E" — is unconstitutional because it interferes with private medical decisions. (2/10)

Reuters: Louisiana Attorneys Appeal Judge's Ruling On Abortion Restrictions
The state of Louisiana on Wednesday asked a federal appeals court to overturn a judge's decision to block a 2014 law that imposed tough restrictions on Louisiana abortion providers and threatened to close four of the state's five clinics. The law requires physicians who perform the procedure to have admitting privileges at a hospital within 30 miles (48 km) of the place where the abortion is performed. In an order filed Wednesday, U.S. Judge John deGravelles finalized his January ruling granting a preliminary injunction sought by abortion providers who argued the law violated women's rights to obtain an abortion. (Brooks, 2/10)

The Associated Press: 2 Texas Researchers Under Fire For Planned Parenthood Study
Two state health researchers in Texas are under fire for co-authoring a study suggesting what Republican leaders have long disputed: cuts to Planned Parenthood are restricting access to women's health care. Texas Health Commissioner Chris Traylor has not said whether the researchers, one a high-level director with more than 20 years in state government, will be disciplined. But a spokesman made it clear that the agency agrees with outraged Republicans over the researchers' contributions to a study that the GOP sees as flawed and biased. (2/10)

NBC News: Groups Denounce Texas Law For Restricting Abortion Access
An abortion law in Texas that opponents say is imposing substantial obstacles for Latinas who want to terminate their pregnancies is headed to the U.S. Supreme Court next month. On Wednesday Latina and women's groups held a rally calling for an end to the law. (Nevarez, 2/10)

The Denver Post: Planned Parenthood Clinic In Colorado Springs To Reopen Next Week
The Planned Parenthood clinic in Colorado Springs is set to reopen next week, more than two months after an attack that left three people dead and several others wounded. The health care provider says the location will resume full service Monday in what is expected to be a tearful — yet joyous — step. About one-third of the building will reopen. (Paul, 2/8)

Public Health And Education

Lawmakers Question CDC Head Over Abortion Funding In $1.8 Billion Zika Request

At a House subcommittee hearing, Centers for Disease Control and Prevention Director Tom Frieden told concerned members that the request does not allocate spending for abortions, a perception public health advocates worry will derail funding. In other Zika news, a Catholic group makes a plea to the pope to allow women to use contraception, WHO offers advice to women, and European researchers discover a clue that may help unlock the mysteries surrounding the virus' effects.

The Wall Street Journal: U.S. Health Officials Expect Significant Zika Cases In Puerto Rico, Other Territories
Federal health officials on Wednesday said the U.S. can expect to see a significant number of Zika cases in Puerto Rico and other U.S. territories where the mosquito that spreads it is likely to appear. On the U.S. mainland, though, the virus’s impact is likely to follow the pattern seen by dengue, another mosquito-borne viral disease, Tom Frieden, director of the Centers for Disease Control and Prevention, told members of two House Foreign Affairs subcommittees in a joint hearing. The dengue virus has appeared in Hawaii, Florida and Texas but hasn’t been widespread throughout the country. (Armour, 2/10)

Reuters: Catholic Group Urges Pope To Allow Contraception To Fight Zika
A Roman Catholic group appealed to Pope Francis on Wednesday to allow Church members to "follow their conscience" and use contraception or to let women have abortions to protect themselves against the Zika virus. The appeal came as the World Health Organization (WHO) advised women in areas with the virus to protect themselves, especially during pregnancy, by covering up against mosquitoes and practising safe sex with their partners. (Pullella, 2/10)

The Associated Press: Study Finds Zika Virus In Fetal Brain, A Clue In Outbreak
New details about the possible effects of the Zika virus on the fetal brain emerged Wednesday as U.S. health officials say mosquito eradication here and abroad is key to protect pregnant women until they can develop a vaccine. European researchers uncovered an extremely abnormal brain — not only a fraction of the proper size but lacking the usual crinkly neural folds — in a fetus whose mother suffered Zika symptoms at the end of the first trimester while she was living in Brazil. (Neergaard, 2/10)

USA Today: Report Paints Heartbreaking Picture Of Zika-Linked Birth Defects
A new report paints a heartbreaking portrait of the damage suffered by babies with microcephaly, a normally rare birth defect linked to the Zika outbreak in Brazil. New research suggests that the damage can go far beyond the size of a baby's skull, and that babies with microceophaly who survive their infancy may need a level of intensive care that is in short supply in the developing countries and territories hardest hit by Zika. (Szabo, 2/10)

Sherrod Brown Offers Bill To Advance Comprehensive View Of Drug Addiction

A key point in the measure is that addiction should be treated as a disease not a character flaw.

Meanwhile, the Chicago Tribune reports on the dangers of prescription drug interactions —

The Chicago Tribune: Prescription Drug Harm: Dangerous Mix Leaves Woman Fighting For Life
The first symptoms mimicked the flu. Becki Conway had a sore throat, a dry cough and irritated sinuses. But the next signs were more puzzling. A sharp pain radiated through her chest. Her eyes turned red and itchy. It seemed like she was fighting off some strange bug, or maybe it was just the normal exhaustion of keeping up with twin toddlers. (King and Roe, 2/11)

Dementia On The Decline, Longterm Study Finds

Rates of dementia dropped 44 percent over the past 40 years, according to a Framingham Heart Study that studied 5,200 people whose memories have been tested since 1975. But the decline in Alzheimer's cases was "not significant" and researchers find that risks vary between ethnic groups.

USA Today: Study Finds Dementia Rates Falling Steadily
A long-running study has found that dementia rates fell steadily over the past four decades, most likely due to declining rates of heart disease. Although the Framingham Heart Study involved just 5,200 people, its findings likely reflect a national trend, said co-author Sudha Seshadri, a professor of neurology at the Boston University School of Medicine and a senior investigator with the study. Other research also suggests that dementia rates are declining in the U.S. and other developed countries. (Szabo, 2/10)

NBC News: Some Good News For Dementia: Rates Might Be Going Down
Researchers have found a small piece of good news for people at high risk of some kinds of dementia: it might be possible to delay it or even prevent it. They found falling rates of vascular dementia in people who also happened to improve their heart health. The findings, published in the New England Journal of Medicine, support the idea that what's good for the heart is good for the head. (Fox, 2/10)

Study Raises Concerns About Doctor-Assisted Suicide For People With Mental Disorders

Research in the Netherlands, where assisted suicides for people with severe psychiatric problems is allowed, found that depression and loneliness were cited by patients as reasons they wanted to die. And NPR reports on another public health study the looks into the impact of gender imbalance in animal testing.

The New York Times: Assisted Suicide Study Questions Its Use for Mentally Ill
A new study of doctor-assisted death for people with mental disorders raises questions about the practice, finding that in more than half of approved cases, people declined treatment that could have helped, and that many cited loneliness as an important reason for wanting to die. The study, of cases in the Netherlands, should raise concerns for other countries debating where to draw the line when it comes to people’s right to die, experts said. (Carey, 2/10)

NPR: A Fix For Gender-Bias In Animal Research Could Help Humans
There's been a male tilt to biomedical research for a long time. The National Institutes of Health is trying to change that and is looking to bring gender balance all the way down to the earliest stages of research. As a condition of NIH funding, researchers will now have to include female and male animals in their biomedical studies. (Bichell, 2/10)

State Watch

Ariz. House Panel Gives Nod To Bill To Restore Kids' Health Insurance Program

The panel's vote moved Arizona a step closer to joining ranks with 49 other states that publicly fund health-insurance coverage for children in low-income families. The state froze enrollment in the KidsCare program in 2010 amid state budget cuts. Meanwhile, in other state legislative news, Wisconsin's budget committee approved additional funding for the state's mental health institutions, California's health plan tax continues to make progress and Georgia's dental hygienist bill is still on hold.

The Associated Press: House Panel OKs Bill Restoring Children's Health Insurance
A bill to provide health insurance for thousands of Arizona children cleared a hurdle Tuesday as lawmakers unanimously passed a measure to lift a freeze on a program covering low-income kids. The coverage known nationally as the Children's Health Insurance Program at one time enrolled more than 63,000 Arizona children whose parents earned between $27,000 and $40,000 for a family of three. (Velzer, 2/10)

The Associated Press: Panel Approves $15.8M For Mental Health Institutes
The Legislature's budget committee overwhelmingly approved state health officials' request Wednesday to pump millions of dollars more into upgrades at Wisconsin's mental health institutions. The Department of Health Services asked the Joint Finance Committee for authorization to spend an additional $15.8 million beyond the state budget on improvements and additions at the Mendota Mental Health Institute in Madison, the Winnebago Mental Health Institute near Oshkosh and three centers for the mentally disabled in Madison, Union Grove and Chippewa Falls. (Richmond, 2/10)

The Associated Press: Insurers Back Proposed California Health Plan Tax
Most of California's health insurance companies said Wednesday they're supporting Gov. Jerry Brown's plan to restructure a tax on health plans. As the administration worked to line up votes, state Assembly and Senate committees heard a generally supportive message from the industry that would pay the tax. Support from insurers, and their assurance that premiums won't rise, is critical to winning support from the needed two-thirds of lawmakers. (Cooper, 2/11)

Georgia Health News: Dental Hygienist Bill Remains On Hold, But Prospects Improving
For the second time in two weeks, a health committee of the Georgia House tabled a bill Tuesday that would allow dental hygienists to practice in safety-net settings without a dentist present. But a hearing on House Bill 684 showed there was new dialogue between Rep. Sharon Cooper, chair of the House Health and Human Services Committee, and the Georgia Dental Association about the proposal. (Miller, 2/10)

State Highlights: Massachusetts To Step Up Nursing Home Oversight; Proposed Mergers Among Major Ohio Insurers Cause Consumer Concerns

News outlets report on health issues in Massachusetts, Ohio, North Carolina, Missouri, Colorado, Iowa, New York, Maryland, Minnesota, Iowa, Rhode Island and Texas.

The Boston Globe: State Officials Move To Tighten Oversight Of Nursing Homes
Massachusetts health regulators moved Wednesday to significantly strengthen oversight of nursing homes, creating a unit that will conduct unannounced inspections and promising to impose fines on problem-plagued facilities. The overhaul, unveiled by the state’s public health commissioner, also calls for intensified scrutiny of companies and executives seeking licenses to run nursing homes. (Lazar, 2/11)

Modern Healthcare: Mercy Inks First Virtual Care Deal With UNC Healthcare
The University of North Carolina Healthcare is expanding its telemedicine program through a partnership with Mercy Virtual, the virtual care arm of Chesterfield, Mo.-based Mercy.The collaboration is a new take on a common theme: telemedicine meets clinically integrated network. And it will allow faster and broader telemedicine adoption than if each health system tried to build its own independent program. (Kutscher, 2/10)

The Denver Post: Colorado Hospitals Claim Billions In Community Benefit Programs
Dad is 66. He just lost his wife of 38 years to a short illness and can't seem to cope without her. To make matters worse, he retired two months before she died. His 34-year-old daughter invites him to meals and outings, but he doesn't seem to see or know his grandchildren. He just sits and stares into space for much of the day, locked into his grief. Dad, in this case, is a character in a scenario, a subject for suggestions from about 20 employees of Longmont United Hospital. He's part of a mental health first-aid course that aims to make treating the mind as normal as treating the body. (Olinger, 2/10)

The Des Moines Register: Iowa Sees Big Drop In Uninsured Children
The number of uninsured Iowa children fell by one-third in just a year, a new report says. From 2013 to 2014, the state saw the number of uninsured children drop from more than 38,000 to fewer than 25,000, the Robert Wood Johnson Foundation says in a report being released Thursday morning. The decline was mainly due to more children joining public insurance plans, mainly Medicaid or Hawk-I. Medicaid is for poor or disabled children. Hawk-I is for children of moderate income families. (Leys, 2/11)

The New York Times: Cuomo’s Proposal Seeks Confidentiality For Minors With H.I.V.
Among the recent patients at the Children’s Hospital at Montefiore in the Bronx was a 17-year-old with H.I.V. who put off his treatment until he turned 18, because he was worried his parents would kick him out and not pay for his medications if they found out about his status. At SUNY Downstate Medical Center in Brooklyn, doctors wanted to prescribe Truvada, the preventive H.I.V. pill, to a 16-year-old girl who was dating a man who was H.I.V. positive. But she did not receive it because she could not qualify for state assistance to pay for it. A new proposal from Gov. Andrew M. Cuomo’s office seeks to remedy such situations by extending to minors the confidentiality that is already given to them for the treatment of other sexually transmitted infections. (Otterman, 2/10)

Minnesota Public Radio: Report Shows Massive Racial Disparities In Health Care
White Minnesotans tend to receive better health care than people of color, a new report compiled by MN Community Measurement indicates. Generally, white and Asian patients had the highest rates of optimal care, while American Indian and black patients usually had the lowest rates, according to the report. The analysis draws on data collected from Minnesota clinics and patients. (Benson, 2/10)

The Chicago Tribune: Is Risk Of State Discipline Scaring Away Doctors From Medical Marijuana
The patients seeking medical marijuana inquire almost daily with Dr. Rahul Khare at his storefront health care clinic in Lincoln Park. They come with cancer, spinal cord diseases, rheumatoid arthritis. Some have been turned down for a cannabis referral by the doctors they see regularly, not because they might not qualify, Khare contends, but because many physicians are hesitant to refer anyone for marijuana. (McCoppin, 2/10)

The Associated Press: Data: Preventable ER Visits Cost About $90M A Year
A state agency says a new report shows potentially preventable emergency room visits cost Rhode Islanders about $90 million a year. The report released Tuesday by the Executive Office of Health and Human Services says nearly $40 million of that is private health care spending, $33.1 is Medicare spending and $18 million is Medicaid. (2/10)

The Star Tribune: Social Security Targets Disabilities Fraud In Minnesota
Federal and state investigators plan to make it a lot harder for people like James W. Smith to defraud the government out of disabilities benefits. Smith, a former IT supervisor from Hermantown, Minn., feigned early-onset dementia to collect more than $264,000 in monthly disabilities payments from the Social Security Administration and a private insurer before he was caught in 2012 and sentenced to 15 months in federal prison. (Browning, 2/10)

The Texas Tribune: With 4 Candidates In Health Care, Senate Race Stirs Unique Debate
Like Republicans across the state and much of the country, all six of the GOP candidates running for Senate District 24 have voiced opposition to President Obama’s signature health law, the Affordable Care Act. They also all support the state maintaining its opposition to expanding Medicaid coverage, despite a long-standing offer by the federal government to cover most of the extra costs for expanding coverage to more low-income Texans. (Walters, 2/10)

The Des Moines Register: Doctor Fined For Improper Internet Prescriptions
A Quad Cities doctor who admitted on national TV last year that he prescribed pain medication to unfamiliar patients via the Internet has agreed to pay a $10,000 fine. Dr. Paul Bolger, 44, reached a settlement with the Iowa Board of Medicine last week, according to documents released Wednesday. (Leys, 2/10)

The Des Moines Register: Iowa Doctor Fined Over Lyme Disease Treatment
A northern Iowa physician has agreed to pay a $5,000 fine after being accused of improperly treating numerous patients for Lyme disease even though they didn’t meet standard criteria for diagnosing the condition. Mary Pat Rosman, 59, who used to practice in Sumner, also was accused of failing to accurately diagnose and treat a case of lung cancer. (Leys, 2/10)

Weekend Reading

Longer Looks: Zika; Staying Sober; McDonald's At The Hospital

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

Vox: Obama Has A New Plan To Fight Zika, Asks Congress For $1.8 Billion
What makes Zika so unnerving is that it was virtually unknown in the Western Hemisphere until arriving in Brazil in 2014, likely during the World Cup. Since then, it has spread rapidly throughout South America and the Caribbean, carried by the notoriously pesky Aedes aegypti mosquitoes. So far, only about a dozen people in the United States have been infected, mostly travelers from abroad. But the virus is expected to arrive in Florida, Texas, and other Southern states during the spring and summer mosquito season. (Brad Plumer, 2/8)

The New York Times: Staying Sober After Treatment Ends
Getting sober is hard. Making sobriety last is much harder. Most people who go into a residential rehab treatment manage to detox and stay that way during their weeks- or months-long stay. But problems begin when they leave. Many patients walk out the door — and fall off a cliff. (Tina Rosenberg, 2/9)

The Atlantic: When The Hospital Serves McDonald's
Even as medical researchers discover more about the foods that keep our bodies well, many hospitals continue to serve foods that promote disease. Last year, the Physician’s Committee for Responsible Medicine (PCRM), a nonprofit group composed of 12,000 doctors, issued a damning report about the healthfulness of hospital food in the U.S. Of the 208 hospitals surveyed, 20 percent housed fast-food restaurants like McDonald’s, Chick-fil-A, and Wendy’s on their campuses. (Shilpa Ravella, 2/9)

FiveThirtyEight: Asking Women To Avoid Pregnancy Is Absurd, Even In The Face Of Zika
In addition to declaring a “public health emergency of international concern,” the World Health Organization has said pregnant women should aggressively avoid getting bitten by mosquitoes. The U.S. Centers for Disease Control and Prevention, as well as the Public Health Agency of Canada and several European countries have issued advisories for pregnant women who are considering traveling to the majority of countries in Latin America and the Caribbean. Several Latin American countries — including Brazil, Colombia, Ecuador, El Salvador and Jamaica — have made far more dramatic asks, saying women should delay getting pregnant altogether. (Barry-Jester, 2/5)

The New York Times: Willie Wood Made The Most Memorable Play Of Super Bowl I. He Has No Recollection.
Doctors are unsure if [Willie Wood's] mental failings are from aging, football or both. Many former players have had chronic traumatic encephalopathy, a brain disease whose symptoms include dementia and erratic behavior attributed to repeated head blows, but it can be diagnosed only posthumously. In 2007, Wood left his home to enter assisted living. In a newspaper interview shortly after the move, he said the highlight of his day was waking up in the morning. But the worst moment of his day always quickly followed. (Bill Pennington, 2/5)

The Atlantic: The Essentials For Giving Birth Around The World
For most expecting mothers in the Western world, a hospital bag is something that makes the birthing process marginally more comfortable. You’ve just brought a new being into the world; you deserve to wear your own sweatpants. But in some parts of the world, hospitals are so bare-bones that women in labor must tote everything with them, from rubber gloves to water pans to gauze. (Olga Khazan, 2/8)

Editorials And Opinions

Viewpoints: Conservatives And The Cancer Moonshot; The Challenges Of Getting To Universal Health Care

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

National Review: Conservatives Can — And Should — Play A Role In The Cancer Moonshot
Last Monday, the White House announced the formation of its Cancer Moonshot Task Force, a follow-up to President Obama’s State of the Union exhortation to “make America the country that cures cancer once and for all.” At the time, the president’s announcement elicited snickers from many on the right concerned about expansive government programs that promise more than they can deliver. But conservatives who worry about the government’s role in combating cancer are missing a key part of the picture: When it comes to making big gains against cancer, it’s not about central planners generating solutions from whole cloth; it’s about making sure nothing gets in the way of the cutting-edge treatments that are already within our reach. (Paul Howard, 2/8)

The Wall Street Journal's Washington Wire: Behind The Challenges To Universal Health Coverage
Both Democratic presidential candidates are calling for universal health coverage, though they disagree sharply on how to get there. Here’s the bottom line: There is no single program or policy likely to achieve full coverage of the complex collection of subgroups who make up the remaining uninsured in the U.S. except for a single-payer strategy. But Sen. Bernie Sanders has acknowledged that single-payer health care is not politically feasible in the foreseeable future and has said that it is unlikely without, among other things, campaign finance reform first. (Drew Altman, 2/11)

JAMA: Is “Firing” The Patient An Unintended Consequence Of Value-Based Payment?
How frequent is the practice of “firing” patients? Research is sparse, but one recent survey found that one-fifth of pediatricians said they had dismissed families for refusing childhood immunizations. If you Google “firing patients,” you’ll find discussions about whether physicians and group practices can fire patients, under what circumstances, and how physicians can do so ethically and legally. (Diana Mason, 2/10)

The Baltimore Sun: 'Risk Adjustment' Threatens Obamacare
The single biggest threat to the survival of the Affordable Care Act (ACA) is not the Republican-led legislative effort to repeal it. Nor is it inadequate enrollment. It is inaction by the administration's own agency that is tasked with implementing Obamacare: the Centers for Medicare and Medicaid Services (CMS), a division of the Department of Health and Human Services (HHS). (Peter Beilenson, 2/10)

The New England Journal Of Medicine: On The Road (to A Cure?) — Stem-Cell Tourism And Lessons For Gene Editing
In 2011, football quarterback Peyton Manning went on the road to seek out stem-cell “treatment” for his neck. He wasn’t alone: many high-profile athletes and desperate (but less famous) patients left the United States seeking interventions available in countries with less rigorous regulation. They didn’t necessarily know what kind of cells they were getting, whether there was any evidence the intervention worked, or whether anyone understood the risks they were taking. So why did they do it? (R. Alta Charo, 2/10)

The Wichita Eagle: Medicaid Expansion Helps Kansans, Hospitals And Economy
A new proposal for expanding Medicaid is smart and Kansas-focused. It also addresses objections to expansion raised by Gov. Sam Brownback and some lawmakers. But GOP leaders in Topeka are still resistant, blocking an attempt Wednesday by Rep. Jim Ward, D-Wichita, to force a House vote on expansion. Senate Bill 371 and House Bill 2633 are based on an expansion plan developed by the Kansas Hospital Association. It was modeled after Indiana’s law and contains several requirements and reforms championed by free-market conservatives. (Phillip Brownlee, 2/10)

The Des Moines Register: Leave Health Care To Experts
Iowa lawmakers should stop trying to micromanage the practice of medicine in this state. Our elected officials are not researchers or scientists or even physicians. Yet they too often want to require that health providers order specific tests or provide specific notifications to patients. The latest offender is Senate File 2057. This bill requires all babies born in Iowa to be tested for cytomegalovirus. Known as CMV, the congenital virus can result in hearing loss and developmental disabilities. Sen. Janet Petersen, D-Des Moines, who introduced the bill, has a constituent who gave birth to an infant with CMV. (2/10)

The New England Journal Of Medicine: Lead Contamination In Flint — An Abject Failure To Protect Public Health
The dangers of lead exposure have been recognized for millennia. In the first century a.d., Dioscorides observed in his De Materia Medica that “lead makes the mind give way.” The first industrial hygiene act passed in the colonies, in 1723, prohibited the use of lead in the apparatus used to distill rum, because “the strong liquors and spirits that are distilld through leaden heads or pipes are judged on good grounds to be unwholsom and hurtful.” More recently, large amounts of lead were used to boost the octane rating of gasoline and improve the performance of paint. One would be challenged to design a better strategy for maximizing population exposure to a poison than to have it emitted by a ubiquitous mobile source and to line the surfaces of dwellings with it. (David C. Bellinger, 2/10)

The Columbia (S.C.) State: DHEC Needs Funding To Protect Public Health And Safety
Rivers that aren't being monitored often enough for us to know whether the fish are safe to eat. Air-monitoring equipment that’s so broken-down that officials don’t know whether it’s safe to issue permits for new industry. Underground storage tanks and abandoned gold mines that aren’t being cleaned up to stop gasoline and acid and metals from leaching into the groundwater. And the giant hazardous waste dump on the shore of Lake Marion that we can’t even monitor properly, much less shore up to prevent water contamination of unimaginable proportions. It shouldn’t surprise anyone that the state Department of Health and Environmental Control — the agency charged with making sure we have clean water to drink and clean air to breathe and that the people who cook our meals and provide our medical care don’t infect us — says it doesn’t have the money to do its job. (2/10)

Los Angeles Times: Should All Women Not On Birth Control Give Up Drinking?
The American medical establishment instructs pregnant women to not drink alcohol, and those who ignore this advice — like those who do not breast-feed their children — are subject to social shaming. Is the circle of shame about to get a lot bigger? Citing the dangers of fetal alcohol spectrum disorder, the Centers for Disease Control last week released an advisory that directs women of childbearing age to abstain from alcohol entirely unless they are on birth control. This recommendation, which unduly burdens women between the ages of about 15 and 44, is deeply troubling on both scientific and ethical grounds. (Rebecca Kukla, 2/10)

Washington Examiner: Certificate Of Need Laws Hurt Both Competition And Patients
The argument in support of CONs is straightforward. The restrictions on competition fostered by such laws provide a way for hospitals to collect more money from some patients, in order to subsidize care for those who can't afford it — a kind of backdoor socialism in which the private sector takes on the role of redistributor of income. But research by Chris Coopman and Thomas Stratmann at the Fairfax, Va.-based Mercatus Center at George Mason University, a free-market think tank, debunks the theory that CONs provide a boost to charity care. (John Bicknell, 2/11)