KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

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Political Cartoon: 'Back Of The Line'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Back Of The Line'" by Mike Keefe.

Here's today's health policy haiku:


Is it possible?
That teens still don't understand
tanning bed dangers?

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CMS Releases Sweeping Rules For Private Medicaid Plans

Highlights of the 653-page proposed regulation for Medicaid managed care organizations include profit guidelines, new standards for doctors and hospital networks, as well as quality ratings for their plans.

Kaiser Health News: ‘Milestone’ Rules Would Limit Profits, Score Quality For Medicaid Plans
Sweeping proposals disclosed Tuesday would create profit guidelines for private Medicaid plans as well as new standards for the plans’ doctor and hospital networks and rules to coordinate Medicaid insurance more closely with other coverage. “We are taking steps to align how these programs work,” said Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, which proposed the rules. Privatized Medicaid has grown rapidly as budget-pinched states have responded to commercial insurers’ promise to deliver care for a fixed price. Most beneficiaries of Medicaid — state programs for the poor run partly with federal dollars — now get care through contracted insurers. (Hancock, 5/26)

National Journal: The Obama Administration’s New Medicaid Rule Has Health Plans Fuming
The Centers for Medicare and Medicaid Services unveiled reams of proposed managed care rules for the low-income insurance program; this is the first time that the agency is revising the regulations since 2002. They cover everything from network adequacy and beneficiary protections to long-term care, which is new ground for federal regulations. But managed care companies, private health plans that cover Medicaid enrollees while receiving a per-member payment from the government, had been bracing for one proposal in particular: Medical-loss ratio. Medical-loss ratio says that health plans have to spend a certain percentage of money that they are paid on actual health care. (Scott, 5/26)

The Hill: Feds Unveil Long-Awaited Overhaul Of Medicaid Managed Care
The Centers for Medicare and Medicare Services (CMS) is proposing that Medicaid managed care groups align their standards with those in the private marketplace to create more uniform practices across states. Those changes will help to “ease the administrative burden on issuers and regulators” while also providing “an appropriate level of protection for enrollees,” CMS wrote in the rules. But the proposed rule is likely to draw fire from many of the 39 states that have enjoyed considered leeway in their own use of managed care. (Ferris, 5/26)

Bloomberg: U.S. Insurers Facing Tighter Oversight Of Medicaid Plans
The proposed rules, issued Tuesday by the Centers for Medicare & Medicaid Services, call for plans to report what portion of the money they’re paid actually gets spent on health benefits, and say states should take that into account when setting rates. The proposed guidance would also have states set standards for access to doctors and hospitals, and create a ratings system for plans. (Tracer, 5/26)

Modern Healthcare: Sweeping Medicaid Rule Targets Enrollment Boom In Private Plans
The CMS has released a sweeping proposed rule intended to modernize the regulation of Medicaid managed-care plans. Medicaid managed-care enrollment has soared by 48% to 46 million beneficiaries over the past four years, according to consulting firm Avalere. By the end of this year, Avalere estimates that 73% of Medicaid beneficiaries will receive services through managed-care plans. (Dickson, 5/26)

CQ Healthbeat: Medicaid Officials Release Long-Awaited Managed Care Rule
Medicaid plans would have to spend a minimal amount of their revenues on medical costs rather than administrative expenses, under a long-awaited proposal that federal Medicaid officials released Tuesday. The proposed rule would streamline regulations that were last updated in 2003. Since then, managed care plans have become grown to cover a rising portion of the Medicaid population, including an increasing number of people with long-term service needs or disabilities. (Adams, 5/26)

Health Law Issues And Implementation

States Consider Teaming Up To Support Their Cash-Strapped Health Exchanges

With federal funding for the state-run health insurance marketplaces expiring, California and Oregon are looking into the possibility of combining efforts into a multi-state exchange. New York and Connecticut have also held preliminary talks. Meanwhile, Republicans discuss White House negotiation tactics in case the Supreme Court rules the federal exchange subsidies illegal. And that is not the only question before the justices that could impact health care policy.

The Fiscal Times: How the GOP Could Box in the White House on Obamacare
A group of Republican Senators is getting ready for a game of chicken with the administration if the Supreme Court strikes down Obamacare health care subsidies. Sen. Ron Johnson (R-WI) and a handful of senators are rallying around a contingency plan if the court rules against the administration in King v. Burwell and eliminates health subsidies for millions of people currently enrolled in the federal exchange,, Politico first reported. (Ehley, 5/26)

Capitol Hill Watch

Senate Republicans Back Bill Allowing For Sale Of Over-The-Counter Birth Control

Some women's reproductive health organizations like Planned Parenthood have opposed the idea, which they argue could drive up contraception prices or consumer coverage costs. Elsewhere, veterans' groups are applauding Senate passage of a bill that allows more choice in doctors.

The Hill: GOP Senators Call For Over-The-Counter Birth Control
Sen. Cory Gardner (R-Colo.) is leading a new push to allow women to buy birth control without a prescription, hoping to deliver on one of the biggest promises of his freshman Senate campaign last year. A half-dozen Senate Republicans have signed onto Gardner’s bill, which would require drug companies that sell contraceptives to file an application to sell their products over the counter. (Ferris, 5/26)

CQ Healthbeat: Republicans Push Over-the-Counter Contraception
A pair of Senate Republicans introduced an over-the-counter birth control bill last week – something that the GOP first began floating during campaign season last year in an effort to show that they support women’s health – but some outside groups are questioning the effect it would actually have on costs, access and pregnancy rates. (Zanona, 5/26)

CQ Healthbeat: Veterans' Advocates Cheer Passage Of Change To Non-VA Medical Care
Veterans’ organizations on Monday applauded the Senate’s action on Friday clearing legislation (HR 2496) that made changes to the Veterans’ Choice program and provided additional funds that allowed work to continue on a costly health center construction project in Denver. The bill, which President Barack Obama signed into law, tweaked language in the law that created the Choice program last year (PL 113-146). The original text said that veterans could be eligible for VA-paid private medical care outside of VA facilities if they faced an unusual or excessive burden in traveling to a VA facility because of geographic challenges. (Adams, 5/26)

The Kansas Health Institute News Service: Senate OKs Moran-Sponsored Bill That Clarified When Vets Can Get Non-VA Care
The U.S. Senate has approved bipartisan legislation to clarify the circumstances when veterans are allowed to get medical care from their hometown providers at the expense of the U.S. Department of Veterans Affairs. Access to local, non-VA health care is part of the Veterans Access, Choice and Accountability Act, which became law last year. It’s meant to assist veterans who live far from VA facilities or can’t get an appointment within 30 days. (Thompson, 5/26)

The growing painkiller and heroin abuse crisis -- which is also driving up hepatitis C cases -- prompts a flurry of legislative proposals -

Politico Pro: Congress Ramps Up Response To Opioid Epidemic
With dozens of Americans fatally overdosing on prescription painkillers and heroin every day, Congress is taking steps to intervene by expanding access to addiction treatment, increasing the use of medication to reverse overdoses and other measures. Lawmakers’ flurry of legislation comes on top of similar treatment and prevention pronouncements by the Obama administration. (Villacorta, 5/26)


Tech Companies, Hospitals And Labs Blocking Electronic Exchange Of Medical Records

A fear of losing business to competitors is driving resistance to the federal government's push toward digital records. In other health industry news, it is estimated that the average data breach cost for companies is $3.8 million. Meanwhile, the market outlook is uncertain for 6 new proton-beam centers soon to open. And the improved economic outlook for the health care industry has increased demand for travel nurses.

The New York Times: Tech Rivalries Impede Digital Medical Record Sharing
Since President Obama took office, the federal government has poured more than $29 billion into health information technology and told doctors and hospitals to use electronic medical records or face financial penalties. But some tech companies, hospitals and laboratories are intentionally blocking the electronic exchange of health information because they fear that they will lose business if they share information on patients with competing providers, administration officials said. In addition, officials said, some sellers of health information technology try to “lock in” customers by making it difficult for them to switch to competing vendors. (Pear, 5/26)

Reuters: Cost Of Data Breaches Increasing To Average Of $3.8M, Study Says
The cost of data breaches is rising for companies around the world as sophisticated thieves target valuable financial and medical records, according to a study released on Wednesday. The total average cost of a data breach is now $3.8 million, up from $3.5 million a year ago, according to a study by data security research organization Ponemon Institute, paid for by International Business Machines Corp. (5/27)

The Wall Street Journal: Big Bets On Proton Therapy Face Uncertain Future
Six new proton-beam centers are set to start delivering state-of-the-art radiation to cancer patients around the country by year’s end. ... The projects, long in the works, will enter an uncertain market. Proton-beam therapy, a highly precise form of radiation, has been dogged by a lack of evidence that it is better than traditional radiation despite costing significantly more. Many insurers including UnitedHealth Group Inc. and Aetna Inc. have stopped covering it for prostate cancer, once seen as a main source of patients. One center closed last year and several others have racked up millions of dollars in losses. (Beck, 5/26)

Kaiser Health News: Improved Economy, Obamacare Boost Demand For Travel Nurses
[Amy] Reynolds is one of thousands of registered nurses who travel the country helping hospitals and other health care facilities in need of experienced, temporary staff. With an invigorated national economy and millions of people gaining health coverage under the Affordable Care Act, demand for nurses such as Reynolds is at a 20-year high, say industry analysts. That’s meant Reynolds has her pick of hospitals and cities when it’s time for her next assignment. And it’s driven up stock prices of the largest publicly traded travel-nurses companies, including San Diego-based AMN Healthcare Services and Cross Country Healthcare of Boca Raton, Fla. (Galewitz, 5/27)

Insurers, Drug-Benefit Managers Seek To Link Drug Prices To Effectiveness

The sky-rocketing costs for new drugs are propelling the effort. But pharmaceutical companies suggest there are better ways to set new pricing models. Also in the news, two patients are suing Anthem Blue Cross, alleging that the insurer would not pay for an expensive new Hepatitis C drug, and a rebuff by the Supreme Court is raising interest among drug makers.

The Wall Street Journal: New Push Ties Cost Of Drugs To How Well They Work
Express Scripts Holding Co., a large manager of prescription-drug benefits for U.S. employers and insurers, is seeking deals with pharmaceutical companies that would set pricing for some cancer drugs based on how well they work. The effort is part of a growing push for so-called pay-for-performance deals amid complaints about the rising price of medications, some of which cost more than $100,000 per patient a year. Some insurers and prescription-benefit managers are pushing back by arguing that they should pay less when drugs don’t work well in certain patients. Drug companies are countering with pricing models of their own, such as offering free doses during a trial period. (Loftus, 5/26)

The Wall Street Journal's Pharmalot: Consumers Sue Anthem For Denying Coverage For A Gilead Hepatitis C Drug
The controversy over the new crop of hepatitis C treatments has taken yet another turn as consumers are starting to file lawsuits against insurers that deny them access to the medicines. Over the past two weeks, two different women alleged that Anthem Blue Cross refused to pay for the Harvoni treatment sold by Gilead Sciences because it was not deemed “medically necessary.” The issue emerges after more than a year of debate over the cost of the medicines and complaints by public and private payers that the treatments have become budget busters. The new hepatitis C treatments, which are sold by Gilead Science and AbbVie, cure more than 90% of those infected and, in the U.S., cost from $63,000 to $94,500, depending upon the drug and regimen, before any discounts. (Silverman, 5/26)

Politico Pro: Supreme Court Turns Down Drug-Disposal Law Challenge
Local drug disposal laws are likely to be high on the pharmaceutical industry’s radar now that the Supreme Court has declined to review an Alameda County, Calif., ordinance that puts drug manufacturers on the hook for funding a prescription drug take-back program. (Karlin, 5/26)

Campaign 2016

Bernie Sanders Kicks Off Candidacy With A Focus On Key Health Issues

At his first official presidential campaign rally, the Vermont senator hammered his progressive vision, including a “Medicare-for-all” system of universal health care.

The Los Angeles Times: Bernie Sanders Launches Presidential Campaign With Populist Pitch
Liberal Sen. Bernie Sanders of Vermont publicly declared his presidential candidacy Tuesday with a demand for what he labeled the nation's billionaire class: "Your greed has got to end." ... Sanders, a self-declared socialist, reiterated his key issues -- income inequality, economic uncertainty, campaign finance reform and climate change -- and outlined what he called a "simple and straightforward progressive agenda" to deal with them. ... He also proposed going beyond the Affordable Care Act to a Medicare-for-all system, as well as free public colleges and universal preschool. (Memoli, 5/26)

The New York Times: Bernie Sanders Challenges Hillary Clinton At His First Rally
Senator Bernie Sanders of Vermont began drawing implicit contrasts with Hillary Rodham Clinton on Tuesday in the race for the 2016 Democratic presidential nomination, as he played the liberal purist in throwing down policy gauntlet after gauntlet – a $15 minimum wage, $1 trillion for public works jobs, a “Medicare-for-all” system of universal health care — in his first campaign rally since declaring his candidacy last month. (Healy, 5/26)

NBC News: Bernie Sanders: Campaign Will Be 'A Movement of Millions'
The self-described democratic socialist has championed many of the positions liberals are pushing for, like raising the minimum wage, free college tuition and universal access to health care. He also is a staunch opponent of the Trans-Pacific Partnership trade deal that fellow progressives like Massachusetts Sen. Elizabeth Warren oppose, but Clinton has not yet taken a firm position on. (Rafferty, 5/26)

CBS News: Bernie Sanders: "Enough Is Enough"
The senator laid out his liberal agenda, including ideas like raising the federal minimum wage to $15 an hour, implementing a Medicare-for-all health care system, investing $1 trillion in infrastructure, make tuition in public universities free, combating climate change, and rolling back the impact of the Supreme Court's Citizens United decision. (Condon, 5/26)

On the Republican side of the race, probable candidates spoke out on health care issues: Jeb Bush called for more Alzheimer’s research funding and a faster drug approval process; Ohio Gov. John Kasich defended his state's Medicaid expansion; and Rick Santorum prepares to run again -

The New York Times: Jeb Bush Signals More Funding And Faster Drug Approval For Alzheimer’s
Former Gov. Jeb Bush opened up last week about his mother-in-law’s affliction with Alzheimer’s disease and, on Tuesday, shed some light on what he thinks should be done to fight the illness. In an email exchange with Maria Shriver, the journalist, activist and author, Mr. Bush wrote that he has been getting a lot of feedback since revealing that his family has firsthand experience with the disease. As for how he would address Alzheimer’s disease, which according to the Centers for Disease Control afflicts five million Americans, Mr. Bush called for more research funding and a faster drug approval process. (Rappeport, 5/26)

Columbus Dispatch/Atlanta Journal Constitution: Critics Of Medicaid Expansion Don’t Bother Him, Kasich Tells Georgia GOP
Fitzgerald noted that the possible Republican presidential candidate had expanded Medicaid under the Affordable Care Act. “Is that a sustainable model long-term?” the GOP activist asked. Kasich first noted that his application of Medicaid expansion to prisoners and the mentally ill actually would save his state money in the long run. ... But in the end, Kasich sounded a note that Georgia Republicans have heard only rarely. “My (other) choice in that decision was to ignore some of the most vulnerable people in our population,” the governor said. “I’ve been criticized for this decision. Do you think it bothers me? It doesn’t.” (Galloway, 5/26)

USA Today: Santorum Poised To Join 2016 Field
Former senator Rick Santorum is poised to once again seek the Republican presidential nomination. The former senator and House member is set to announce his decision about a 2016 bid at an event in Butler County, Pa., near his boyhood home, late Wednesday afternoon. He would join a growing GOP field that is likely to include more than a dozen candidates. (Allen, 5/27)

A 2016 Senate race takes shape, as Sen. John McCain, R-Ariz., gets an opponent for his seat -

Reuters: Arizona Congresswoman To Challenge Senator John McCain
Three-term Arizona Democratic Congresswoman Ann Kirkpatrick said on Tuesday she will seek to oust powerful Republican John McCain from his U.S. Senate seat in 2016. ... Under the campaign slogan “Putting Arizona First,” she ticked off a list of issues that she has pursued, including improving education, protecting farms and ranches, caring for veterans, fighting for Social Security and Medicare, and paying down the national debt. (5/26)

Public Health And Education

CDC Responds To Lassa Fever Death In N.J.

Federal officials are tracing the victim's travels and treating the case with caution, as the virus can be spread from person to person in rare cases. Lassa fever shares symptoms with Ebola, but is nowhere near as deadly -- nearly 99 percent of people survive it.

The New York Times: New Jersey Lassa Fever Death Prompts C.D.C. Action
After the government spent months constructing a health monitoring system for Ebola that strikes a balance between protecting public safety and preserving personal liberty, a patient in New Jersey seems to have squeezed through it. The patient, who was not identified, died from Lassa fever on Monday night. The viral disease is not nearly as deadly as Ebola, but it is endemic in several West African countries, as well as contagious, and it sent local and federal health officials scrambling to trace the man’s steps in the four days between his hospitalizations. (Tavernise and Hartocollis, 5/26)

NPR: How Worried Should We Be About Lassa Fever?
An unidentified New Jersey man died after returning home from West Africa, where he had contracted Lassa fever, a virus that has symptoms similar to those of Ebola. Federal health officials are treating the case with caution because the virus, which commonly is spread by rodents, can occasionally spread from person to person. Lassa fever can cause internal bleeding. Other symptoms include respiratory distress, vomiting, facial swelling, and back and abdominal pain. Dr. Tom Frieden, who heads the Centers for Disease Control and Prevention, says the virus is not nearly as deadly as Ebola. Ninety-nine percent of people with Lassa fever survive. (Harris, 5/26)

HHS Awards $112M To Help Doctors Fight Heart Disease

The grants will be used to create regional groups of experts to help smaller medical practices. News outlets also report on other public health issues, including new evidence about umbilical cord care after birth, concerns about college students and tanning beds, some doctors' reluctance to order colon cancer screening and new efforts to fight Alzheimer's disease.

The Hill: HHS Boosts Effort To Fight Heart Disease
The Department of Health and Human Services (HHS) on Tuesday announced $112 million in grants aimed at helping doctors at smaller practices fight heart disease, the leading cause of death in the U.S. The grants will be used to create regional groups of experts who will provide assistance to smaller practices, which tend to have fewer resources than large organizations. (Sullivan, 5/26)

NPR: Delayed Umbilical Cord Clamping May Benefit Children Years Later
A couple of extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later, a study suggests. Children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ. (Haelle, 5/26)

USA Today: Waiting A Few Minutes To Cut Umbilical Cord Helps Baby
Cutting the cord is a momentous event in a baby's life. For nine months, the developing fetus is attached to its mother by the umbilical cord. Then, moments after birth, that cord is severed. Now, research suggests there may be benefits to keeping mom and baby attached a few minutes longer. (Weintraub, 5/26)

Kaiser Health News: Tanning Beds And College Campuses – A Public Health Concern
Tanning salons are already under siege – they got taxed by the health law, are newly regulated by the federal government and states, and have become dermatologists’ favorite bad guy. But some policymakers say that’s not enough. Pointing to rising skin cancer rates and increased marketing toward young people, these public health advocates want new national restrictions regarding who can get their indoor tan on. “It’s time we started treating [tanning beds] just like they are cigarettes. They are carcinogen delivery systems,” said Rep. Rosa DeLauro, D-Conn., at a May 20 Capitol Hill briefing on the dangers of indoor tanning. “We do not allow our children to buy cigarettes, yet the tanning industry continues to target adolescent girls. And this is not unlike what we found with the tobacco industry.” (Gillespie, 5/27)

The Associated Press: Peeking Into Healthy Brains To See If Alzheimer's Is Brewing
Sticky plaque gets the most attention, but now healthy seniors at risk of Alzheimer’s are letting scientists peek into their brains to see if another culprit is lurking. No one knows what actually causes Alzheimer’s, but the suspects are its two hallmarks — the gunky amyloid in those brain plaques or tangles of a protein named tau that clog dying brain cells. New imaging can spot those tangles in living brains, providing a chance to finally better understand what triggers dementia. (Neergaard, 5/25)

State Watch

Fla. Senate Offers Compromise On Medicaid Impasse

Senators say the proposal meets concerns from House members about Medicaid expansion and allows the lawmakers to reach a budget in the special session that begins next week. But, at least initially, the offer did not garner approval from the governor or House leaders.

The Associated Press: Florida Senate Offers Health Care Coverage Compromise
Republican leaders in the Florida Senate offered up a revamped health care proposal Tuesday in an effort to end a budget stalemate that threatens to shut down state government, but the proposal was immediately rejected by Gov. Rick Scott and House GOP leaders. Legislators are scheduled to return to the state Capitol next week for a 20-day special session where they are expected to pass a new state budget. (Fineout, 5/26)

Naples (Fla.) Daily News: Florida Senate Develops New Plan To Use Medicaid Money For Health Care Expansion
The state Senate proposed an amendment Tuesday to it plan to use federal Medicaid expansion money to provide health care to 800,000 uninsured Floridians through health exchanges .... But the plan did little to win over House GOP leaders or [Gov. Rick] Scott. The proposed changes to the Senate plan, which is termed the Florida Health Insurance Exchange [FHIX], would eliminate an earlier proposal to enroll the uninsured in Florida’s Medicaid system. Those 800,000 would receive health care coverage through exchanges, with Medicaid expansion money used to cover the cost. (Dixon, 5/26)

Tampa Bay Times: Seeking Breakthrough, Senate Offers Changes To Its Health Plan
The revised bill addresses a number of House criticisms of the Senate's proposal. The changes to the Senate health care plan (formerly SB 7044 and now called SB 2A) include eliminating a requirement that patients in the Senate FHIX plan (Florida Health Insurance Affordability Exchange) must first enroll in a Medicaid managed care plan for six months; revises enrollees' searches for jobs to be through the state workforce portal, known as Career Source; gives patients the option of enrolling in health care plans available on a federal health care exchange; and prohibits the state from seeking a federal waiver to implement FHIX that varies significantly from the legislation. (Bousquet, 5/26)

Tampa Bay Times: Rift Widens Between Governor And Senate -- They Now Disagree About Budget Hole
Tensions continued to mount Tuesday between Gov. Rick Scott and the Senate as the governor blasted a Senate compromise and the governor’s Agency for Health Care administration issued a letter to the federal government suggesting that the state would not lose the $1 billion in federal money to reimburse hospitals for serving the uninsured under the low income pool as legislators previously suggested. (Klas, 5/26)

Texas Lawmakers Pass Bill Requiring Special Stickers On Marketplace Insurance Cards

Advocates say the marking will help remind customers to pay their monthly premiums, but critics wonder why such a designation is needed. In other news from state legislatures, efforts have stalled in California on Gov. Jerry Brown's plan to expand a tax to more managed care plans and in Oregon on a bill to institute a state-wide sick leave policy.

The Texas Tribune: Health Insurance Card Bill Clears Senate
House Bill 1514, which would add a special label to the health insurance cards of people purchasing health plans on the exchange created by the Affordable Care Act, passed the Texas Senate late Tuesday evening. The bill ... would apply to more than a million Texans with “qualified health plans” purchased on by adding a new label — “QHP” — to their insurance cards. It passed 20-11 and now heads to Gov. Greg Abbott for approval. Doctors’ groups say the bill would help physicians remind their patients to continue making monthly payments toward their health insurance premiums .... But critics wondered why the special designation was needed. (Walters, 5/26)

The Sacramento Bee: Jerry Brown’s Proposal To Expand Health Plan Tax Sputtering
Gov. Jerry Brown’s plan to make more managed care organizations pay a state tax – one likely to be passed on to consumers – is meeting resistance at the Capitol. A major part of Brown’s proposed health care budget, the expanded tax on managed-care organizations would raise an estimated $1.7 billion to help pay for health care for the poor and pay for a court settlement ending a years-long legal fight over reduced hours for home-care workers. (Miller, 5/26)

The Oregonian: Democratic Lawmakers Frustrated By Oregon Legislature's Failure To Pass Paid Sick Days Bill
Ten Democratic lawmakers and their allies expressed frustration Tuesday at the Legislature's failure to pass a statewide paid sick-leave bill. When the session began in February with large Democratic majorities in both the Senate and House, advocates expected Oregon to quickly become the fourth state with a law mandating paid leave for workers. But with Memorial Day signaling the final weeks of the session, two paid sick-leave bills continue to languish in committee despite months of pre-session work to craft a law acceptable to business, labor and members of both political parties. (Rede, 5/26)

Insurance Rates May Rise In Kansas And Iowa Next Year

The Kansas Insurance Department projected that the state may see hikes as high as 38 percent in some plans. In Iowa, Conventry Health Care wants to raise rates by 18 percent.

State Highlights: N.Y. Home Health Care Standards; Nursing Shortage In Ill.; W.Va. 20-Week Abortion Ban In Effect

News outlets report on health issues from New York, Illinois, West Virginia, California, Kentucky, Puerto Rico, Kansas, North Carolina, New Jersey and Missouri.

Reuters Health: N.Y. Home Health Workers Do Not Always Meet Standard--Report
Home health workers in New York do not always meet federal and state requirements for health screenings and training, according to a new report from the U.S. Department of Human Services' Office of Inspector General. The report, released on Tuesday, looked at a sample of 150 Medicaid claims for home health services in New York from 2007 to 2009, and found that home care workers involved in 15 of the claims did not meet federal and state requirements. (Pierson, 5/26)

The Associated Press: New Survey Suggests Nursing Shortage Looming In Illinois
A new survey conducted by the Illinois Department of Financial and Professional Regulation suggests the state may soon face a shortage of registered nurses as more and more baby boomers retire. The voluntary survey, known as the 2014 Illinois Registered Nurse Workforce Study, was completed by nearly 53,000 registered nurses, or around 30 percent of the total in Illinois. (5/26)

The Associated Press: West Virginia 20-Week Abortion Ban Takes Effect
A law prohibiting abortions 20 weeks after conception took effect Tuesday in West Virginia, despite Gov. Earl Ray Tomblin twice vetoing the ban over concerns that a court could strike it down. Amid the Democratic governor’s worries over constitutionality, state Attorney General Patrick Morrisey, a Repubilcan, has vowed to defend the ban against potential legal action. (5/26)

The Associated Press: California Bill Compels Abortion Notice At Pregnancy Centers
Californians who visit crisis pregnancy centers must know whether the facility is licensed and that abortion is an option under legislation advanced Tuesday by the state Assembly. AB775 advanced on a party-line vote with Republicans saying it would violate free speech protections. The bill responded to reports of misinformation at pregnancy centers that are opposed to abortion, including an unsubstantiated link between abortion and breast cancer. (Nirappil, 5/26)

The Associated Press: Overdose Reversal Kits Being Supplied To More Ky. Hospitals
Hospital system on the front lines of treating heroin overdoses in hard-hit northern Kentucky will be supplied with hundreds of naloxone kits to send home with overdose patients in an effort to combat the deadly toll from the drug scourge. An emergency nurse manager said Tuesday the overdose reversal kits will save lives and provide a starting point for conversations about treatment. (Schreiner, 5/26)

The Washington Post's Wonkblog: Already Deep In Debt, Puerto Rico Now Faces A New Crisis
Puerto Rico has been laid low for nearly a decade by crippling debt and a near-perpetual recession that has triggered a migration to the U.S. mainland unmatched since the 1950s. Now, a growing number of people on the island worry that another crisis is looming: the collapse of the island’s health-care system. More than 2 million patients—roughly 60 percent of Puerto Rico’s population—rely on Medicare, Medicare Advantage or Medicaid to pay for their health care. Doctors practicing in Puerto Rico are forced to get by with much smaller Medicare and Medicaid reimbursement rates than those received by their counterparts on the mainland. The difference stems from a formula that Puerto Rico advocates say underestimates commercial rents, while not fully accounting for high costs of malpractice insurance, medical equipment and utilities. (Fletcher, 5/26)

North Carolina Health News: NC Group Home Money Allegedly Hidden In House Budget
Group home providers are being told there’s money to support their residents with mental health disabilities, but the fix hasn’t been spelled out. Since changes driven by a 2012 settlement North Carolina made with the U.S. Department of Justice over mental health funding, getting the money needed by group homes has been a challenge. (Hoban, 5/27)

NJ Spotlight: Nurse-led, Team-focused Health Care Inspires Providers In NJ
Healthcare providers and insurers across New Jersey are looking for ways to become more efficient and effective in the way they deliver care to patients – particularly those with chronic diseases who make the most visits to hospitals. Some are finding inspiration in a small nonprofit across the Delaware River in Pennsylvania. Doylestown, Pa.,-based Health Quality Partners has gained national attention using a nurse-led, team-based model of providing intense, closely coordinated healthcare. (Kitchenman, 5/26)

The St. Louis Post-Dispatch: Missouri Hemp Oil Program Slow To Take Off
When Missouri agreed to allow the use of hemp extract to treat severe forms of epilepsy, Marc DeSantis was hopeful his 8-year-old son, Lucas, would benefit. Lucas has various brain malformations and, at times, has had more than 200 seizures in a day. Having tried more than a dozen other medications to little avail, Marc DeSantis began to look to hemp oil. But that excitement would soon turn to frustration. Under Missouri’s law, hemp oil can be obtained only with the approval of a neurologist who must certify that more standard forms of treatment were ineffective at treating seizures. (Shapiro, 5/27)

Editorials And Opinions

Viewpoints: Don't Trust Health Law Memories; Good Compromise In Fla.; Smoking And The Poor

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

Bloomberg View: Obamacare's Intent? Just Read The Law
Memory is so very terrible, and this [health] law is so very complex. Anyone who tells you that they have a full and accurate memory of the evolution of the various moving parts is lying -- at least to themselves. They are incapable of being accurate about what must have seemed like a minor point in a law that was drafted five years ago. That's why the Supreme Court largely ignores post-hoc statements, and we should too. ... In the absence of a clear record of legislative intent, which we don't have, we have to go back to where we should have been in the first place, the place from which the Supreme Court is going to rule: the text of the law. (Megan McArdle, 5/26)

The Washington Post: On The Origins Of ‘Established By The State’ In The Affordable Care Act
If Congress did not mean to refer to state-established exchanges, why did it use the phrase “established by the State”? According to story by Robert Pear in the New York Times “the words were a product of shifting politics and a sloppy merging of different versions. Some described the words as ‘inadvertent,’ ‘inartful’ or ‘a drafting error.'” In other words, by this account it was a mistake — and a mistake no one noticed until well after the bill’s passage. This may be how congressional staffers and legislators characterize the drafting process now, but that’s not what the federal government and its supporting amici told the Supreme Court. (Jonathan H. Adler, 5/26)

The Charlotte Observer: The SC 'Blind Guy': Anatomy Of A Viral Health Care Story
I marked 34 years in newspaper journalism this month, and I’ve never had a story grab public interest the way my recent post on Luis Lang did. The account of the uninsured Fort Mill, S.C., Republican seeking someone to pay for his sight-saving surgery pushed people’s buttons across the country. Even as he raised more than $25,000 from donors, readers lined up to scold him for seeking aid while living in a $300,000 home. People couldn’t wait to give him a virtual earful about smoking, neglecting the diabetes that put him at risk for blindness and blaming Obamacare for the Medicaid gap created by South Carolina lawmakers. (Ann Doss Helms, 5/25)

Tampa Bay Times: Senate Offers Path To Victory For All On Medicaid Expansion
The Florida Senate has drawn a new road map for House Republicans to get to yes on accepting Medicaid expansion money. Tuesday's proposed revisions to a bipartisan proposal to use the federal money to help pay for private coverage for low-income Floridians answer their strongest objections and should lower the demagoguery in next week's special legislative session. House leaders ought to be able to claim credit for forcing the adjustments and join their Republican colleagues in the Senate to embrace a proposal that is fiscally responsible and lets everyone claim victory. (5/26)

The Chicago Sun-Times: Safety-Net Hospitals Endangered By Rauner Budget Knife
Illinois Gov. Bruce Rauner wants to cut $735 million in Medicaid spending to Illinois hospitals, reductions that naturally will fall most heavily on hospitals that serve the poor in Chicago. The hospitals say Rauner’s cuts would force them to eliminate important services and, in some instances, even force hospitals to close. (Mark Brown, 5/22)

Bloomberg View: Smoking's Growing Income Gap
The income gap between smokers and nonsmokers has grown. And it's something companies may need to address directly in their efforts to help employees kick the habit. Over the past several decades, smoking rates have fallen sharply among high-income, highly educated Americans and not as much for less educated, low-income people. The result is that, in 2013, the smoking rate exceeded 20 percent for people with a high school degree or less while among those with a graduate degree it was just 5.6 percent. Among people living in poverty, smoking was almost twice as common (29 percent) as among those at or above the poverty line (16 percent). (Peter R. Orszag, 5/26)

Houston Chronicle: Pre-Term Babies Cost Us All
Babies born too soon suffer fragile health and exact a high cost on our public health system. That's especially so for the babies born to Medicaid-eligible women and those who qualify for state-supported perinatal care. The estimated cost for a preterm birth in Harris County is $39,371. That's about 12 times more than the cost of a full-term birth that's covered by health insurance. If these statistics are not sobering enough, consider this: The care of a preterm infant generally does not stop when the baby leaves the hospital, but continues into childhood and beyond. (June Hanke, Catherine Clark Mosbacher and Luis Rustveld, 5/26)