KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Facing Death But Fighting The Aid-In-Dying Movement

A young mother with a grave lung disease worries that a California bill that would make assisted suicide legal could pressure terminally ill people to end their lives. (Stephanie O'Neill, Southern California Public Radio, 5/20)

Political Cartoon: 'New Kid On The Block?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'New Kid On The Block?'" by Bob and Tom Thaves.

Here's today's health policy haiku:

PRICE TAG ANXIETY

Some states fear higher
costs because Medicaid grew
more than expected.

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 IT

Carefirst: Hackers Had Access To Personal Info For More Than 1M Customers

CareFirst, a Blue Cross Blue Shield plan, is the third major U.S. health insurer to disclose this year that hackers breached its computer systems. The attack occurred in June 2014.

The Wall Street Journal: Health Insurer CareFirst Says It Was Hacked
CareFirst BlueCross BlueShield said Wednesday that hackers had gained access to the personal information of more than a million consumers, becoming the third major health insurer this year to disclose a breach. The not-for-profit insurer, which serves the District of Columbia, Maryland and parts of Virginia, said the attack occurred in June 2014 and involved a database where it stored information that members and others enter to access its websites and other services. CareFirst said the hackers may have acquired user names as well as members’ names, birth dates, email addresses and subscriber numbers. (Wilde Mathews and Yadron, 5/20)

The Washington Post: Cyberattack On CareFirst Exposes Data On 1.1 Million Customers In D.C., Md. And Va.
The CareFirst attack occurred in June 2014, according to a Web site set up by the insurer. The company said its cyber-security team thought it had fended off the attack at the time, but a recent review discovered that the attackers had gained access to the usernames that customers created on its Web site as well as their real names, birth dates, e-mail addresses and subscriber identification numbers. The database the hackers accessed did not contain members' Social Security numbers, medical claims, employment, credit card or financial information, the company said. (Peterson, 5/20)

The Associated Press: CareFirst Says Data Breach Affects About 1.1M People
Health care data breaches have grown over the last few years, and researchers at security software maker Symantec say the health care industry has become a major target for cyber criminals. That's partly because their systems may be more easily breached than banks and retailers, which were frequent targets in years past. (5/20)

Politico Pro: CareFirst Hacked, 1.1M Customers At Risk
CareFirst, a BlueCross BlueShield health plan serving Maryland, D.C., and Northern Virginia, was the victim of a “sophisticated” cyberattack in June last year, the company said Wednesday, putting at risk limited personal information about 1.1 million customers. (Pittman and Demko, 5/20)

Modern Healthcare: Impact Of CareFirst Cyberattack Compounded By Old Data
The sophisticated cyberattack against CareFirst Blue Cross and the record-breaking hacks at Premera Blue Cross and Anthem would have a narrower impact if insurance companies didn't retain customer data for so long, experts say. CareFirst, which provides health insurance and administrative services for about 3.4 million people in Maryland, the District of Columbia and Northern Virginia, said Wednesday that it was the victim of a cyberattack that affected 1.1 million current and former CareFirst members who have used the company's online tools. (Rubenfire, 5/20)

USA Today: FireEye Has Become Go-To Company For Breaches
When news broke Wednesday that as many as 1.1 million CareFirst health insurance customers could have had their personal information stolen, one familiar name was included: FireEye. The Milpitas, Calif.-based security firm has made a name for itself as the experts pulled in when a big computer security issue arises. "They've ended up being the go-to people. If there's a data breach, that's a name you hear," said John Kindervag, a security analyst with Forrester Research. (Weise, 5/21)

Health Law Issues And Implementation

Florida GOP Fights Obama Administration For Hospital Funds Linked To Medicaid Expansion

The letter from Republicans in Congress seeks continuation of the funding for hospitals with large numbers of uninsured patients, but federal officials say expanding the Medicaid program under the health law is a better option. Many Florida Republicans oppose that. In the meantime, a report shows that emergency room visits in New Hampshire fell 22 percent following Medicaid expansion there.

Tampa Bay Times: Florida Republicans Urge Obama To Reconsider LIP
A group of Florida Republicans wrote a letter to President Obama urging him to reverse a decision to end the Low Income Pool program in Florida, arguing it "has been working to help low-income families in our state." The request won't go anywhere, but represents the call to arms that Gov. Rick Scott sent up during a trip to Washington last week. (Leary, 5/20)

Washington Times: Marco Rubio, GOP House Members Back Fla. Governor In Medicaid Standoff With Obama Admin
Presidential candidate Marco Rubio and other Florida Republicans urged President Obama on Wednesday to renew federal funding for health program at the center of a festering dispute between Gov. Rick Scott and the administration, which wants the state to expand Medicaid under Obamacare instead. Their letter to the president comes days after Mr. Scott, a Republican, personally asked congressional Republicans to wade into the fight. (Howell, 5/20)

New Hampshire Union Leader: Report: Emergency Room Visits By Uninsured Down 22%
Emergency room visits by uninsured patients fell 22 percent in the first three months of 2015 compared to same time period in 2014, a drop that New Hampshire hospitals attribute to Medicaid expansion. In a report released Wednesday, the New Hampshire Hospital Association also said inpatient admissions of the uninsured fell by 27 percent. (Hayward, 5/20)

Also in the news, GOP presidential hopeful Jeb Bush's health care record -- particularly on Medicaid -- is scrutinized.

Politico: Jeb Bush’s Medicaid Fix: More Choices, Fewer Benefits?
In education and immigration, Jeb Bush is an outlier in the Republican presidential field — a moderate who raises concerns about the ideological direction of the party. But on another flash-point issue, health care, Bush is a proven conservative, having put into action ideas that some GOP rivals can only talk about. Bush cites his 2005 effort to overhaul Florida’s broken and expensive Medicaid program as a model for using market-driven reforms to cut the growth of health spending and rein in a big government program. It’s not a full-fledged GOP alternative to Obamacare, but it’s a starting point. (Haberkorn, 5/221)

Study: Little Difference In Access To Care, Quality In Narrow Networks

The study, published in Health Affairs, looked at plans offered on California's health insurance exchange. Elsewhere, exchange rate hike proposals get scrutiny, and Colorado officials propose upping their exchange staff and move to bring their marketing in-house.

Coverage And Access

Rising Out-Of-Pocket Expenses Drive Up Number Of 'Underinsured'

A study estimates that 31 million people, many with private health insurance coverage, face unaffordable medical bills when seeking care. That forces many to put off doctor visits.

The Associated Press: Study: 23 Percent Of US Adults With Health Coverage Underinsured
Nearly a quarter of U.S. adults who were insured all last year lacked adequate protection from big medical bills based on their income, according to Commonwealth Fund research. The nonprofit foundation estimates that about 31 million people between the ages of 19 and 64 were underinsured due in part to the out-of-pocket expenses they have to pay for care. That includes deductibles, or payments a patient has to make before most coverage begins. (5/20)

Marketplace: Even With Insurance, People Avoid The Doctor
Among people 65 and under, almost two-thirds are covered by private health insurance plans, according to the CDC. But that doesn’t mean health care is affordable. A report released today by the Commonwealth Fund shows that rising deductibles and other out-of-pocket expenses are a serious problem for more than 30 million underinsured working-age adults. (Douban, 5/20)

Medicare

Senate Panel Asks Medicare To Revamp Programs To Cut Number Of Observation Stays

At a meeting of the Senate Special Committee on Aging, Sen. Susan Collins, R-Maine, pointed out that observation care status can cost Medicare beneficiaries thousands of dollars in out-of-pocket costs.

Modern Healthcare: Medicare Recovery Audit Program Targeted For Reform After Spike In Observation Stays
Members of the U.S. Senate Special Committee on Aging called on the CMS during a hearing Wednesday to make changes to Medicare's recovery audit contractor program, which some providers have identified as a driving force behind the rise in observation stays in recent years. Committee members encouraged the agency to implement recommendations recently backed by the Medicare Payment Advisory Commission, in addition to making other changes to address the "hospital observation stay crisis." (Adamopoulos, 5/20)

McKnight's Long-Term Care News: Collins: Patients Stuck In 'Medical Twilight Zone' From Observation Stays
Hospital observation stays leave a Medicare beneficiary in a “medical twilight zone,” Sen. Susan Collins (R-ME) said at the Senate Special Committee on Aging committee hearing Wednesday. Too often, patients do not know the type of care they are receiving or for how long they have to be there, Collins said. Those under observation status can sometimes end up paying thousands in out-of-pocket costs, often when they land in post-acute care, she observed. Typically, an observation stay is only supposed to last 24 hours, she noted. But the length of these stays have grown, sometimes exceeding 72 hours. (Petrovich, 5/20)

Maine Public Radio: Maine Nurse Testifies On Medicare Problem
A Maine nurse urged federal lawmakers to put an end to a practice that can saddle seniors on Medicare with unexpected medical bills. Tori Gaetani of Beacon Health, part of Eastern Maine Healthcare Systems, testified before a Senate Aging Committee hearing on the problem of Medicare patients who spend time in the hospital under what is called "observation status" but are not actually admitted. Medicare does not pay for any skilled nursing care a senior under observation status might need. Gaetani asked lawmakers to change the rules. (Leary, 5/20)

Capitol Hill Watch

Grassley Urges Tighter Scrutiny Of Medicare Advantage Plans; House 'Cures' Bill Mark Up Delayed

In other Capitol Hill happenings, supporters of the 340B Drug Discount program urge lawmakers not to make changes in it as part of the "Cures" bill that would overhaul the FDA's drug approval process. Meanwhile, House Speaker John Boehner, R-Ohio, gives a bleak VA progress report.

The Hill: Medical Cures Bill Hits Setback
The House Energy and Commerce Committee on Wednesday abruptly delayed a markup of its bipartisan medical cures bill for 24 hours over the question of how to pay for the legislation. The 21st Century Cures measure, aimed at streamlining the Food and Drug Administration (FDA) approval process for new cures, was scheduled for a markup Wednesday morning, but the committee delayed it until Thursday with less than two hours' notice. The committee’s chairman, Rep. Fred Upton (R-Mich.), told reporters Wednesday that members are still in talks about cuts to mandatory spending programs in order to offset the cost of the bill. (Sullivan and Ferris, 5/20)

The Wall Street Journal's Pharmalot: Hospitals Urge Congress Not To Change A Drug Discount Program
As a Congressional committee readies legislation designed to jump start medical innovation, executives representing more than 500 hospitals are urging Congressional leaders not to make changes to a prescription drug program that serves indigent patients and bolsters their own bottom lines. At issue is the 340B Drug Discount program that requires drug makers to offer discounts of up to 50% on all outpatient drugs – for everything from AIDS to diabetes – to hospitals and clinics that are known as safety net hospitals, because they serve indigent populations. (Silverman, 5/20)

CQ Healthbeat: Drug Discount Program Backers Tell Congress To Wait For Regulations Before Legislating
Supporters of a federal program that requires drug companies to give certain hospitals and other providers discounts on medications urged House lawmakers Wednesday to wait to see new draft guidance from the Health Resources and Services Administration before revising the program. The Office of Management of Budget now has under review two proposals from HRSA that would change the so-called 340B program, which has been controversial in recent years. (Young, 5/20)

The Associated Press: Boehner: Little Progress At VA Year After Shinseki Departure
The Department of Veterans Affairs is no better off a year after former VA Secretary Eric Shinseki resigned amid a scandal over long wait times for veterans seeking health care and falsified records to cover up the delays, House Speaker John Boehner charged Wednesday. In a speech on the House floor, Boehner said the VA has made little progress since Shinseki resigned, despite a new law that overhauled the agency and authorized $16 billion in new spending over three years. (5/20)

In other congressional news -

The New York Times: House Sends Human Trafficking Bill To President’s Desk
The House overwhelmingly approved the Senate’s much debated human trafficking bill on Tuesday, sending legislation that stalled in the Senate for six weeks to President Obama’s desk with little fanfare. ... Moving past the disagreement over a provision that would block money in a victims’ fund from being used to pay for abortions, the Senate passed the bill, 99 to 0, in April after party leaders agreed to split the fund. Though money for health care would be subject to an existing ban on using federal money to pay for abortions, many victims would be able to obtain abortions in cases of rape. (Huetteman, 5/20)

Marketplace

Hedge Fund Manager Challenges Drug Patents Using New Dispute Process

Meanwhile, Johnson & Johnson estimates that 10 new drugs the company wants to bring to market could reap $1 billion in annual sales. In other research news, a group of virus hunters aims to change the ways insurers and countries handle Ebola and other epidemics.

CQ Healthbeat: Hedge Fund Manager Takes Aim At Pharmaceutical Patents
A Texas hedge fund manager is using a recently created federal dispute process to challenge patents for medicine, spurring calls from drugmakers for Congress to address what the companies call an abuse of the intellectual property system. Dubbing his effort the Coalition for Affordable Drugs, J. Kyle Bass of Hayman Capital Management casts his work as a bid “to police the abusive tactics of the worst offending drug companies.” His battle will involve less than 1 percent of the more than 3,500 branded prescription medicines, he said in a letter last month to House lawmakers. (Young, 5/20)

The Associated Press: Johnson & Johnson Expects Lucrative Return On Drug Pipeline
Johnson & Johnson is predicting big returns from its prescription drug business, both financially and medically, as it develops treatments and strategies to intervene earlier and prevent or reduce the damage from several conditions, including Alzheimer's disease and diabetes. The world's biggest maker of health care products said Wednesday that it plans to seek approval by 2019 for more than 10 new medicines, each with blockbuster potential - at least $1 billion in annual sales. (Johnson, 5/20)

The Wall Street Journal: Virus Hunter Metabiota Finds Niche In Epidemic Research
A group of virus hunters in San Francisco may be closer to changing the way insurers, companies and countries deal with the risk of another Ebola outbreak. Their company, Metabiota Inc., uses a staff of epidemiologists and researchers in 20 countries to provide forecasts and data on outbreaks. Most of its clients are U.S. government agencies, but in the past three years the firm has pushed deeper into the private sector. On Wednesday Metabiota said it raised $30 million in a new funding round in part to expand its client base among insurance companies and governments. (Hope, 5/20)

State Watch

Gov. Scott's Hospital Panel Faces Off With Florida Health Officials

The first meeting of the commission created by Florida Gov. Rick Scott to examine government hospital spending ended with a sense that the group won't come up with solutions before the legislature's June 30 deadline to pass a budget that will set health care funding levels.

The Associated Press: Florida Hospital Commission Meeting Echoes Scott's Agenda
Gov. Rick Scott's hospital commission held its first meeting Wednesday, overwhelmed by mounds of data but intent on determining whether hospitals that receive tax money are being managed efficiently. "What are we paying for and what's the result of what we're paying for? Do patients have access, is it quality care and is it affordable?" said Dr. Jason Rosenburg. (Kennedy, 5/20)

Tampa Bay Times: Gov. Scott's Health Care Funding Panel Sparring With Hospitals
A commission that Gov. Rick Scott created this month is facing off with hospitals as it looks for ways to make government spending on health care more efficient. But after the first meeting of the Commission on Healthcare and Hospital Funding on Wednesday, it's clear that solutions won't come until after the June 30 deadline for the Legislature to pass a budget, including on health spending. There's a lot of information for the panel to collect and analyze, chairman Carlos Beruff said. The commission's nine members aren't necessarily tasked with solving the current stalemate over federal funding for Medicaid and the Low Income Pool that expires June 30. Still, their early conversations have centered on those programs and the financial records of hospitals that are reimbursed by government for treating low-income patients. (Auslen, 5/20)

California Medical Association Reverses Position On 'Aid-In-Dying' Legislation

In what might be a national precedent, the doctors' group changed its decades-long opposition to a proposal that allows physicians to help seriously ill patients end their lives.

Nexstar Broadcasting: Cal Medical Assn. Changes Aid In Dying Position
The California Medical Association (CMA) has become the first medical association in the nation to change its stance on physician aid in dying also known as physician assisted suicide. In a release, CMA said it eliminated its historic opposition and is now neutral on the matter. (5/20)

In related news -

Kaiser Health News: Facing Death But Fighting The Aid-In-Dying Movement
Stephanie Packer was 29 when she found out she has a terminal lung disease. It’s the same age as Brittany Maynard, who last year was diagnosed with terminal brain cancer. Maynard, of northern California, opted to end her life via physician-assisted suicide in Oregon last fall. Maynard’s quest for control over the end of her life continues to galvanize the “aid-in-dying” movement nationwide, with legislation pending in California and a dozen other states. (O'Neill, 5/20)

Gaps In State Data Adds Difficulty To Determining Scope Of National Heroin Problem

Pennsylvania and a number of other states only broadly note in official databases information about drug overdoses, but the most recent statistics date to 2012 and generally don't include specific information about the drugs in use. Meanwhile, in related news, a Maine legislator advances a bill to make abuse-deterrent painkillers more affordable and a crackdown on prescription drug abuse in the South leads to charges against two physicians.

NPR: States Lack Accurate Statistics On Widespread Heroin Use
In Pennsylvania, it's estimated opioids like heroin killed at least 1,300 people last year. In Massachusetts, more than 1,000 have died, and in Connecticut, heroin deaths jumped more than 85 percent in two years. But figuring out the size and scope of the problem is harder than many people think. (Allen, 5/21)

NPR: Maine Bill Aims To Make Abuse-Deterrent Painkillers More Affordable
The problem of opiate addiction in Maine is one that state Rep. Barry Hobbins knows something about. "One of my family members has been struggling with this dreaded addiction of opiates for six years," he says. So when pharmaceutical company Pfizer — which makes opioids that have abuse-deterrent properties — asked Hobbins to sponsor a bill that would require insurance companies to cover these more expensive drugs at the same level as other opioids, he agreed. (Wight, 5/20)

The Alabama Media Group: Mobile Pain Docs Arrested In 'Operation Pillution' National DEA Effort Targeting Rx Drug Abuse
Two Mobile doctors are facing federal charges for allegedly committing health care fraud and illegally distributing pain pills. Their arrests were part of a broader effort by federal authorities to crack down on prescription drug abuse in the South. On Wednesday, DEA agents raided pain clinics, pharmacies and other locations in Arkansas, Alabama, Louisiana and Mississippi as part of "Operation Pillution." (Toner, 5/20)

Also from today's headlines -

Nexstar Broadcasting: VA Monitoring Narcotic Use
Military veterans from all over [central Pennsylvania] turn to the Van Zandt V.A. Medical Center for health care. The pharmacy there also manages prescription medicines for vets in and out of the hospital. Some patients may notice a little more scrutiny of their medications, due to a new effort to control the use of narcotic pain killers. (5/20)

State Highlights: Colo. Advocates Step Up Push For Universal Care Plan; Issues Bubble Up For Home Health Care Workers In Mo., Mich.

News outlets examine health care issues in Colorado, Missouri, Michigan, Oregon, Georgia, Florida and New York.

St. Louis Public Radio: Missouri Home Health Care Workers Call On Nixon To Implement Pay Hike
Approximately 80 home health care workers demonstrated outside Gov. Jay Nixon's office Wednesday, demanding that he sign off on an agreement that could lead to their getting higher wages. The agreement between the Quality Home Care Council and the union representing home care workers would set a pay-scale ranging from $8.50 an hour to $10.15 an hour. They currently average around $8.60 an hour, but some earn the state's minimum wage of $7.65 an hour. (Griffin, 5/20)

The Associated Press: Black Health Workers Lose Appeal Over Treating White Patient
An appeals court has upheld a decision that kills a discrimination lawsuit filed by black home health care workers who were told they couldn’t take care of a white patient. The court agreed Wednesday with a Grand Rapids federal judge who said the women waited too long to file a lawsuit against Spectrum Health. Judge Robert Holmes Bell also found that the women couldn’t demonstrate a “long-standing … policy of discrimination” that would let the case go forward. (5/21)

The Denver Post: Mental Health Providers, Lawmakers Raise Red Flags With Colorado Health Services
Four days before more than 80 lawmakers sent Gov. John Hickenlooper a letter saying they had lost confidence in his human services director, the governor received a similar letter from mental health clinics across the state. Mental health clinics have been pushing for contract changes since the Affordable Care Act allowed more people to obtain insurance with mental health coverage. Still, community clinics see people with no insurance and their overall patient numbers have increased. They want to expand their contracts so the state will reimburse them for treating patients whose needs are not as severe, but contracts through the state Office of Behavioral Health have not been adjusted to allow that. (Brown, 5/20)

The Oregonian: Birth Control Access: GOP Lawmaker Revives Plan For Pharmacy Prescriptions
Weeks after his idea was left in political limbo, a Republican lawmaker has revived legislation to expand access to birth control pills by giving pharmacists the power to write on-demand prescriptions. ... If Oregon approves the measure, it would join California as one of only two states willing to let birth control seekers skip a potentially costly doctor's visit. (Theriault, 5/20)

The Miami Herald: Five Busted In Fake-Pharmacy Scheme
The scheme: A ring composed of a doctor, a man whose identity remains hidden and three others paid older folks to order expensive pharmaceutical drugs through Medicare and Medicaid. Then those drugs were repackaged and sold to pharmacies in Florida, Georgia, New York and Puerto Rico. Those pharmacists, police said, had no idea they were often buying stolen and outdated psychopathic and AIDS drugs that could cause harm to their users. (Rabin, 5/20)

Weekend Reading

Longer Looks: The Last Day Of Life; Asking For Organs; Giving Bad News

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

The New York Times Magazine: The Last Day Of Her Life
Sandy Bem, a Cornell psychology professor one month shy of her 65th birthday, was alone in her bedroom one night in May 2009, watching an HBO documentary called “The Alzheimer’s Project.” For two years, she had been experiencing what she called “cognitive oddities”: forgetting the names of things or confusing words that sounded similar. She once complained about a “blizzard” on her foot, when she meant a blister; she brought home a bag of plums and, standing in her kitchen, pulled one out and said to a friend: “Is this a plum? I can’t quite seem to fully know.” … The next month, Sandy’s husband, Daryl, from whom she had been amicably separated for 15 years, drove her from Ithaca to the University of Rochester Medical Center for cognitive testing by a neuropsychologist named Mark Mapstone. … After three hours, Mapstone gave a preliminary diagnosis: amnestic mild cognitive impairment. At first Sandy was relieved — he had said mild, hadn’t he? — but then she caught the look on his face. This is not a good thing, Mapstone told her gently; most cases of amnestic M.C.I. progress to full-blown Alzheimer’s disease within 10 years. ... That day at Mapstone’s office, she vowed that she would figure out a way to take her own life before the disease took it from her. (Robin Marantz Henig, 5/14)

The Atlantic: The Art Of Asking For Human Organs
The exact requirements vary from state to state, but in general, discounting the living donors who give their kidneys and partial livers, organs can be obtained from people in one of two circumstances: Either they’ve been declared brain-dead at the hospital, or they’ve died from heart failure at the hospital. Most deaths, though, take place outside the hospital—in 2012, the national average of hospital deaths across all 50 states was just over 20 percent. Meanwhile, the U.S. faces an organ-donation shortage; around 21 people die each day waiting for an organ transplant, according to the national Organ Procurement and Transplant Network. (Cari Romm, 5/15)

The Wall Street Journal: How Doctors Deliver Bad News
Doctors are trying new ways of solving an old problem—how to break bad news, which is as much a staple of doctors’ lives as ordering blood work and reviewing scans. One issue: Patients and their families, of course, aren’t all going to respond in the same way. Research into the effectiveness of training doctors in how to deliver bad news has turned up mixed results, with patients often not noticing any benefit. (Sumathi Reddy, 5/18)

The Atlantic: Blueprint For A Better Human Body
What was once an industry bent on replicating the human body exactly, the world of prosthetics has started thinking more creatively about what the human body can be. As technology advances, as engineers start to borrow ideas and designs not just from human biology but from elsewhere, and as prosthetics become less stigmatized, there are all sorts of options opening up. The human body, and what people consider the “normal” human body, can be a whole lot more than what’s biologically possible. (Rose Eveleth, 5/17)

The Washington Post: Fertility Medicine Brings Babies — And Tough Decisions
[Brenda] Loblein was 35 when she walked down the aisle for the second time, and she was already a mother to three children from her first marriage. But the meteorological satellite operator knew that she wanted a child with her new husband, and in vitro fertilization was necessary. Today, they have a little boy and a little girl — and, despite Loblein’s best efforts not to create more than they needed, that extra embryo she had wanted to avoid. Waiting in limbo for her to decide its fate. (Ellen McCarthy, 5/18)

Vox: Bernie Sanders Is Unleashing A Plan To Make Prescription Drugs Cheaper
Generic drugs are cheaper versions of drugs that have lost their patent. But in recent years, the prices for generic drugs have been rising quickly and inexplicably. One report from pharmacy benefits manager Catamaran found that consumers paid, on average, $13.14 for each prescription of the 50 most popular generics in 2010. By 2014, they paid $62.10 — a 373 percent increase. (Sarah Kliff, 5/19)

Editorials And Opinions

Viewpoints: Mandate's Limited Effect; Trade-Offs With High-Cost Plans; Texas' Fight With Women

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

The New York Times' The Upshot: Ignoring The Penalty For Not Buying Health Insurance
Obamacare’s big stick doesn’t seem to be scaring many people into buying health insurance. The health law includes many inducements for people to obtain health insurance — including free Medicaid coverage for many low-income Americans and subsidies for those with moderate incomes. But it also includes the notorious “individual mandate,” a fine for those who can afford insurance but don’t buy it. (Margot Sanger-Katz, 5/20)

The Washington Post's Plum LIne: Sick Man Whose Obamacare Story Went Viral Could Be Thwarted By Supreme Court
By now you may have learned of the plight of one Luis Lang, a South Carolina man whose story went viral after it was reported that he couldn’t afford to treat an illness that was threatening to make him blind — and blamed Obamacare for it. He has since come around to the view that Democrats may not be entirely to blame for his state of affairs — and says he is going to try to gain coverage through the law. (Greg Sargent, 5/20)

The Wall Street Journal: The ‘Value’ Trade-Off In High-Deductible Health Plans
A Kaiser Family Foundation survey published Thursday of people who buy insurance in the non-group market found that while many people may choose higher-deductible plans so they can pay a lower premium, they aren’t all that happy about it. It may just be the only way they can get a premium they feel they can afford. (Drew Altman, 5/21)

Orlando Sentinel: Expand Medicaid And Spare Elderly Higher Health Costs
The employer mandate portion of the Affordable Care Act requires employers with 100 or more employees to offer health insurance to all of their full-time workers. In many industries, this means increased costs for business that will be passed on to consumers and taxpayers. Florida's elder-care industry in particular, which includes rapidly growing sectors like nursing homes and home health care, is caught in a bind that the entire state will pay for if Medicaid is not expanded. Large retailers can raise prices by a few pennies to cover the new health benefits for their low-wage employees, but for some industries it is much more complicated. The compensation level for nursing homes and home-health organizations is set by the state via Medicaid reimbursement rates. (Ben Geyerhahn, 5/20)

The Kansas City Star: ACA Eased Pent-Up Demand For Medical Procedures
From time to time Affordable Care Act skeptics have asked me: “The uninsured can always go to an emergency room, can’t they?” Well, yes. If you have a true emergency, an ER has to take care of you without demanding proof of insurance. But the staff has to treat and stabilize you only for your emergency medical condition; they don’t necessarily have to take care of chronic conditions that may be tormenting you. And for whatever treatment they do give you, they can hand you a bill you’ll probably find hard to pay. (Alan Bavley, 5/20)

Health Affairs: How Texas Lawmakers Continue To Undermine Women’s Health
For years, Texas has had the highest proportion of uninsured individuals overall, and for adult women specifically, of any state. In 2013, one in five Texans had no health insurance of any kind, including 2.1 million adult women. Beyond limited access to health coverage, Texas consistently has lackluster health indicators — particularly with regard to sexual and reproductive health care. Yet, at seemingly every turn, state lawmakers continue to implement neglectful, or even hostile, policies that hinder access to affordable sexual and reproductive health care and information, especially among low-income Texas women and teens. (Kinsey Hasstedt, 5/20)

The New York Times: New Blood-Donor Policy, Same Gay Stigma
Last week, the Food and Drug Administration released highly anticipated draft recommendations that would allow gay men to donate blood after one year of celibacy. While an improvement from the current, highly criticized lifetime ban, the new policy, which was announced in December, still caters to fear and stigma rather than science. It should be reconsidered. (I. Glenn Cohen and Eli Y. Adashi, 5/21)

The Charlotte Observer: Local Health Care CEO's Troubling Ouster
It’s hardly unusual for a boardroom shakeup or two to ripple through a corporation. Such upheavals usually play out behind closed doors, with little or no public accounting of who ousted whom and why. That lack of disclosure seems unacceptable, however, when the firm in question uses $635 million in government money to help people dealing with mental illness, substance abuse and developmental disabilities. That’s how big a responsibility the state has entrusted to Kannapolis-based Cardinal Innovations Healthcare Solutions. And that’s why the circumstances around the Cardinal board’s sacking of respected CEO Pam Shipman are troubling. (5/20)

The Philadelphia Inquirer: Telemedicine To The Rescue In Tennessee
Tennessee recently passed a law that requires private health insurance plans and the state’s Medicaid managed care plans to pay for telemedicine services in the same way they pay for health care services being provided in person. Although there were many considerations behind the law, on a very simple level, it just makes good sense. While there are parts of Tennessee that are rich in health care resources, other parts of the state need improved access to care. The easiest way to connect the residents of those areas with health care resources is through telemedicine. (Marcelo H. Fernandez-Viña, 5/20)

JAMA Surgery: Promoting Balance In The Lives Of Resident Physicians
As physicians, we spend a significant amount of time counseling our patients on how to live healthier lives. Ironically, as trainees and practicing physicians, we often do not prioritize our own physical and psychological health. Most residents go to work despite significant physical impairment and severe anxiety. Compared with population controls, residents are more likely to experience burnout and exhibit symptoms of depression. These problems persist into practice .... our residency program took decisive action to create a multifaceted program aimed at enhancing resident wellness. (Arghavan Salles, Cara A. Liebert and Ralph S. Greco, 5/20)