KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

When Prisons Need To Be More Like Nursing Homes

By 2030, nearly one-third of all inmates will be over 55, the ACLU says, and caring for aged prisoners often costs twice as much as caring for younger ones. Some states – New York, California and Connecticut -- are confronting the problem, however, with innovative programs meant to improve care and save money. (Maura Ewing, The Marshall Project, 8/27)

Political Cartoon: 'Calm B-4 The Storm'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Calm B-4 The Storm'" by Dan Reynolds.

Here's today's health policy haiku:

HOSPITALS BARE ALL -- PUTTING QUALITY RANKINGS ONLINE

Power to patients!
Is that the outcome when some
Hospitals post scores?

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

Some States' Big Premium Hikes May Be Talking Point During Enrollment Season, Campaigns

The Wall Street Journal reports that some insurers are winning approval by state regulators of hefty increases in health insurance premiums. Meanwhile, Florida news outlets report on what the numbers look like in that state.

The Wall Street Journal: Insurers Win Big Health-Rate Increases
At a July town hall in Nashville, Tenn., President Barack Obama played down fears of a spike in health insurance premiums in his signature health law’s third year. “My expectation is that they’ll come in significantly lower than what’s being requested,” he said, saying Tennesseans had to work to ensure the state’s insurance commissioner “does their job in not just passively reviewing the rates, but really asking, ‘OK, what is it that you are looking for here? Why would you need very high premiums?’” That commissioner, Julie Mix McPeak, answered on Friday by greenlighting the full 36.3% increase sought by the biggest health plan in the state, BlueCross BlueShield of Tennessee. (Radnofsky and Armour, 8/26)

The Miami Herald: Obamacare Health Insurance Premiums To Rise 9.5 Percent For 2016, State Regulator Reports
Health insurance premiums for Floridians who buy their own plans will rise 9.5 percent on average for 2016, though some consumers will pay less for their coverage than they did this year, state insurance regulators reported Wednesday. A total of 19 health insurance companies submitted rate filings to Florida’s Office of Insurance Regulation, which this year regained the authority to deny rate increases for health plans sold on the Affordable Care Act’s insurance exchange at HealthCare.gov. Average rate changes for 2016 plans sold on the ACA exchange will range from a decrease of nearly 10 percent for some plans, to an increase of as much as 16 percent for others. (Chang, 8/27)

Tampa Bay Times: Premiums For Obamacare To Rise 9.5 Percent Overall In Florida
Floridians who purchase individual health insurance plans under Obamacare will see their premiums rise by an average of 9.5 percent next year, the state Office of Insurance Regulation said Wednesday. That's about $36 per month or $432 per year. The average rate change varies widely by insurance company. Four insurers offering plans on Florida's federally run Affordable Care Act insurance exchange will have average increases in the double digits: Aetna (13.9 percent), Humana (16.3 percent), Preferred Medical Plan (14 percent) and UnitedHealthcare (16.4 percent). But some consumers will end up paying less for health insurance than they did in 2015. Celtic Insurance Co., Health Options, Florida Health Care Plan, and Molina Health Care are set to decrease their rates. (McGrory, 8/26)

Judge Rules Ariz. Hospital Fee To Pay For Medicaid Expansion Is Legal

Lawmakers in Arizona approved the plan, but opponents said the vote required a supermajority, which a judge rejected. In Alaska, lawmakers that have taken Gov. Bill Walker to court over a proposed Medicaid expansion there get their day in court.

The Arizona Republic: Judge: Arizona Medicaid Expansion Was Constitutional
The Arizona Legislature needed only a simple-majority vote to expand the state’s Medicaid program in 2013, a Superior Court judged ruled on Wednesday. The case hinges on whether a hospital assessment lawmakers approved to fund the expansion, which extended health-care coverage to more than 250,000 low-income Arizonans, is a fee, as its proponents argued, or a tax. (Pitzl, 8/26)

The Associated Press: Judge Says Arizona Medicaid Plan Hospital Fee Constitutional
A judge ruled Wednesday that a hospital assessment that pays for the expansion of the state's Medicaid program did not require a supermajority vote of the Legislature to be enacted and is therefore constitutional. The ruling from Maricopa County Superior Court Judge Douglas Gerlach comes more than 18 months after the expansion went into effect and means about 350,000 Arizonans who have gained coverage will continue to receive health care insurance. (Christie, 8/26)

Alaska Dispatch News: Alaska Legislature's Medicaid Lawsuit Gets First Court Hearing Thursday
The Alaska Legislature’s high-stakes lawsuit to stop Gov. Bill Walker from expanding the state’s public Medicaid health care program gets its first appearance in court Thursday. ... Margaret Paton-Walsh, one of the state attorneys managing the team of lawyers working on Walker’s defense, said she expected to be at her office past midnight Wednesday, with a filing deadline at 11 a.m. Thursday. It's not clear, she added, whether Pfiffner would issue a ruling from the bench Thursday, or some time later. The Legislature is seeking a court order that would stop Walker’s administration from acting unilaterally to expand Medicaid under provisions of Obamacare to newly cover up to 40,000 low-income Alaskans. Without an order, expansion is set to take effect Sept. 1, based on a 45-day notice Walker gave a legislative committee in July. (Herz, 8/26)

Support For Health Law Grows To 62% In California, Survey Finds

According to the annual Field Poll, while most Republicans still oppose the law, nearly half say that Obamacare has met key goals like lowering the uninsured rate. Statewide, 58 percent approve of the way California runs its health services.

Another California-based study looks at patient views of the health law's impact on prescription drugs coverage -

California Healthline: Did the ACA Improve Access To Rx Drugs? Some Patients Don't Think So
Health plans offered through the ACA's exchanges are required to cover prescription drugs, but insurers get to decide their own drug formularies -- and those can vary significantly from plan to plan. And while insurers are required to publicly post details of their drug coverage policies, the formularies often are "incomplete, inaccurate or difficult to navigate due to lack of standardization and confusing or inaccessible consumer cost information," according to a California-based study released this month by the California HealthCare Foundation. (Rosenfeld, 8/26)

Capitol Hill Watch

Budget Issues Top Congressional To-Do List When Lawmakers Return To Capitol Hill

Other hot topics include efforts to resuscitate a provision regarding care for medically complex kids that was dropped from the House-passed Cures bill. Patent issues are also emerging.

Reuters: When Congress Returns From Vacation, Budget Fight Looms
Republican Senator Ted Cruz, also a candidate [for the Republican presidential nomination], has led a charge to kill federal funding for Planned Parenthood after secretly taped videos showed technicians for the women's health organization gathering fetal tissue from abortions. Cruz and other conservatives have tried to use must-pass spending bills, like the one coming due Oct. 1, as vehicles to kill Obama's healthcare law and immigration policies. The strategy has failed but has forced temporary agency shutdowns. (8/27)

CQ Healthbeat: Medicaid Kids Bill Seen As Bipartisan Rallying Point
Backers of a plan to ease Medicaid restrictions on treating children with complex medical needs across state lines are trying to make it a bipartisan rallying point after the proposal was dropped from the House-passed “21st Century Cures” bill. Republican sponsor Joe L. Barton of Texas is pressing for a fall hearing on a measure (HR 546) addressing the effects of the program's state-specific coverage requirements and said it could pass as stand-alone legislation. The Senate companion bill is backed by Charles E. Grassley, R-Iowa. (Zanona, 8/26)

CQ Healthbeat: Conservatives Ramp Up Opposition To Patent Legislation
A group of conservative luminaries is distributing a "Memo for the Movement" urging colleagues to oppose House and Senate legislation that would make it more difficult for patent holders to sue others for infringement. The memorandum, which began circulating last Friday, is signed by former Reagan administration Attorney General Edwin Meese III, former Virginia Attorney General Ken Cuccinelli II and former Ohio Secretary of State J. Kenneth Blackwell, among others. (Zeller, 8/26)

Also in the news, the White House plans for the pope's visit -

The Associated Press: Obama To Seek Unity With Pope On Issues In White House Visit
Despite deep differences on some social issues such as abortion, Obama and the pope are expected to focus on areas of agreement. The White House said economic opportunity, immigration and refugees, and protection of religious minorities were high on the agenda. ... When he visited Francis early last year, Obama contradicted the official Vatican account of their meeting by saying they hadn't discussed social issues in any detail. Papal aides insisted the two leaders indeed discussed religious freedom, life and conscientious objection - buzzwords for abortion, birth control and parts of Obama's health care law. (8/26)

Medicare

Protests Seek To Attract Attention To Medicare's Prosthetics Policy Change

Amputee groups, practitioners who work with them and prosthetic limb makers are rallying against a Medicare proposal they say will limit access to some artificial limbs.

The Associated Press: Amputees Decry Medicare Payment Overhaul For Artificial Feet
Famous people don’t often get involved with Medicare payment policy, but a Boston Marathon bombing survivor and a former U.S. senator who lost a leg in wartime service have joined an industry campaign to block new requirements for artificial legs and feet. Medicare’s mounting cost for those items in the last 10 years — even as the number of amputees was declining — has prompted scrutiny from government investigators. (Alonso-Zaldivar, 8/27)

The Washington Post: Amputees Protest Proposed Medicare Changes For Artificial Limbs
Wednesday afternoon’s modest protest was organized to attract outsize attention to concerns by the nation’s amputees — and health practitioners who work with them — that the government might make it more difficult for older and disabled Americans to afford state-of-the-art artificial legs, or any artificial legs at all. Such changes are envisioned in a set of rules proposed by the four regional companies to which Medicare delegates responsibility for the program’s medical device benefits, including artificial limbs. (Goldstein, 8/26)

CNN: Amputees Fight Medicare Proposal To Limit Prosthetics
Amputee groups and prosthetic makers are rallying against a Medicare proposal they say will limit access to some limbs. Under the new proposal, Medicare would establish more stringent requirements to obtain advanced prosthetics, reduce the role of the prosthetist who creates and maintains prostheses, and eliminate some of the universal codes that all providers use to cover prosthetic care. (Kounang, 8/26)

The Minneapolis Star-Tribune: Protest Seeks To Block Medicare Policy Changes On Prosthetics Payments
The changes envisioned by Medicare, the government’s health insurance agency, revise coverage for what are called “definitive prosthetic components.” The proposed rules also require a medical exam by a doctor or health professional other than a prosthetics expert to determine “functionality.” Additionally, the rules mandate participation in a rehabilitation program before amputees can get a “definitive prothesis” and limit Medicare payments for certain adjustments to prosthetics, as well as coverage for certain kinds of prosthetic technology. (Spencer, 8/26)

Quality

Long Island Hospital Puts Quality Rankings Of Its Doctors Online

Meanwhile, Politico Pro reports on a Health Affairs blog post that questions Medicare's penalties for hospitals that have high readmission rates, while the Connecticut Mirror notes that almost all of the hospitals within the state took such a hit.

The Wall Street Journal: Long Island Hospital Posts Doctor Ratings
Amid a Wild West of consumer-ratings sites, North Shore-LIJ Health System is one of only a few hospitals in the U.S. to take matters into its own hands. The Long Island-based hospital network began posting online ratings of its doctors this week, making it the first such organization in the metropolitan area to do so, hospital officials said. (Ramey, 8/26)

Politico Pro: Analysis Casts Doubt On Lower Hospital Readmission Rates
Hospitals are cheating to avoid the Obama administration’s new readmissions penalties, according to a new Health Affairs post — which the authors say casts doubt on achievements that CMS has been trumpeting for several years. Rather than drastically reducing the number of patients readmitted to the hospital within 30 days of discharge, hospitals instead have been relabeling many of those patient visits as “observation stays” that don’t count toward readmission tallies, the authors argue. Others have been treated in emergency departments, which also excludes them from the count. (Mershon, 8/27)

The Connecticut Mirror: Almost All CT Hospitals Face Readmissions Penalties
All but one of Connecticut’s acute-care hospitals will lose Medicare reimbursement in 2015-16 as a penalty for high readmissions of discharged patients, new federal data show. The penalties against 28 hospitals mean Connecticut has one of the highest percentages nationally – more than 90 percent — of hospitals facing Medicare reductions. Only the Hebrew Home and Hospital of West Hartford escaped penalties; the Connecticut Children’s Medical Center is exempted from the federal program. (Chedekel, 8/26)

In other news -

Reuters: U.S. Business Groups Call For Probe Of Medical Funding Industry
Two business lobbying groups this week called on the Consumer Financial Protection Board to investigate the medical funding industry after a Reuters investigation revealed that private investors are funding operations for women who have sued makers of surgical implants. The American Tort Reform Association and DRI-The Voice of the Defense Bar told Reuters on Tuesday that medical funders take advantage of the people they claim to be helping. (Frankel and Dye, 8/26)

Public Health And Education

Public Health Advocates Press White House To Help Expand Use Of Costly Hepatitis Drugs

Also in the news, NPR examines the role of the prescription drug Fentanyl in the current opioid epidemic and a new strategy for some patients to control their diabetes.

The Fiscal Times: Should We Be Rationing Hepatitis Drugs? Obama Pressured To End Restrictions
Amid mounting evidence that federal and state authorities are rationing costly new wonder drugs for treating people with the potentially lethal hepatitis C virus, public health experts have begun pressing the White House to intervene to expand the use of Sovaldi and other new medications. An estimated 3.2 million adults are chronically infected with hepatitis C while an estimated 20,000 people die from the serious liver ailment every year, including many military veterans. (Pianin, 8/26)

NPR: How The Prescription Painkiller Fentanyl Became A Street Drug
If you've ever had surgery, you may have been given an analgesic named fentanyl. Fentanyl is a favored painkiller because it acts fast. But it's also 80 to 100 times more potent than morphine. The powerful drug has made its way to the streets and increasingly is being used to cut heroin — resulting in a deadly combination. (Whitehead, 8/26)

NPR: Texting Helps Diabetes Patients Fine-Tune Insulin Dosing
People whose diabetes requires insulin injections usually have to make a series of visits to the doctor's office to fine-tune their daily dosage. But many low-income patients can't afford to take those few hours off to see the doctor. As a result, they often live with chronically elevated blood sugars for weeks or months until they can find time to get to the clinic. (Shaikh-Lesko, 8/26)

Campaign 2016

On The Trail: Rubio Takes On Planned Parenthood; Clinton Talks About Addiction Issues In Rural America

News outlets report on what candidates are saying on the issues, including those related to health care and public health.

The Boston Globe: Rubio Targets Climate Change, Planned Parenthood In N.H.
US Senator Marco Rubio of Florida, struggling to break through in the Republican presidential primary, delivered a conservative pitch to activists here Wednesday, rejecting climate-change legislation and gun control as ineffectual. Rubio also criticized Planned Parenthood as the purveyor of “atrocious practices,” and said that Democrats would be to blame if a government shutdown occurs as a result of disagreements between the parties about funding the agency. (O'Sullivan, 8/27)

The New York Times: Hillary Clinton Speaks About Farming, And Much More, In Iowa
Growing together was a central theme: She said that creating more clean energy would be a boon to agriculture, that expanded broadband and Internet access would help rural communities, that comprehensive immigration reform would help stabilize the agricultural work force, and that a growing agriculture sector would help combat the drug dependency and addiction plaguing the country. ... “I want to focus on the people of rural America,” she said, her voice becoming hushed as she listed the devastation that drugs have caused in parts of the country. “Meth, pills, overdoses, lost lives, broken families.” She pledged to improve treatment of addiction, and especially in making such facilities available in rural areas for addiction and mental health. (Corasaniti, 8/26)

State Watch

After Katrina Destroyed Charity Hospital, New Orleans Opens Doors To Its Replacement

Many are thrilled with the new medical center, a decade in the making and costing in excess of $1 billion, while others fear that it does not share the mission of serving patients no matter the cost. Meanwhile, other hospital news includes changes to night-shift pharmacies in Charlotte, N.C., a funding grant for psychiatry training at Carolinas Medical Center and a $6.6 million cost-cutting bonus for the Delaware Valley ACO.

The Boston Globe: State Hospitals Report $1.2 Billion In Earnings
Last year was good to most Massachusetts hospitals. Despite fewer patient admissions, more competition, and constant pressure from the government and insurers to control costs, the state’s 62 hospitals maintained their combined earnings of $1.2 billion last year, while more hospitals shared in the profits. All types of hospitals, from small community facilities to big urban medical centers, increased earnings, according to a new report from the state Center for Health Information and Analysis. (Dayal McCluskey, 8/27)

The Charlotte Observer: Novant Health Closes Night-Shift Pharmacies At Charlotte-Area Hospitals
Four days after the July 13 announcement that Novant Health would cut 400 employees, it also shut down the night-shift pharmacies at hospitals in Matthews and Huntersville, two of the system’s four Mecklenburg County hospitals. Dr. Thomas Zweng, chief medical officer for Novant Health, told me the pharmacy closings should not affect nurses’ jobs or patient care because any questions are now being handled by pharmacists at Presbyterian Medical Center, Novant’s largest Charlotte hospital, near uptown. Zweng said the system has cut pharmacy hours at several other hospitals – in Charlotte, Winston-Salem, Thomasville, Kernersville and Brunswick County – because of “low volume.” Having electronic medical records (EMR) allows pharmacists at Presbyterian to access patient records at Matthews, he said. Even before the changes in Matthews and Huntersville, Novant’s Charlotte Orthopaedic Hospital had also moved to “virtual pharmacy” coverage through Presbyterian at night, Zweng said. (Garloch, 8/27)

The Charlotte Observer: Levines Give $3M For Psychiatry Training Program At Carolinas Medical Center
A $3 million gift from the Leon Levine Foundation to Carolinas HealthCare System will be used to launch a residency training program in psychiatry at Carolinas Medical Center, officials announced Wednesday. The first class of three psychiatric residents will enter the four-year program in July 2017. The program will help meet a pressing need for physicians providing behavioral health services in this region, hospital and foundation officials said at a news conference on the CMC campus. (Garloch, 8/26)

The Philadelphia Inquirer: Area Medical Group Gets A Bonus For Cutting Costs
The Delaware Valley ACO, a group of five health systems and 450 primary care doctors that is participating in Medicare's new accountable care organization payment model, got good news recently. The Centers for Medicare & Medicaid Services (CMS), which operates Medicare, announced late Tuesday that it is giving the local group a $6.6 million reward for lowering costs last year. This puts DVACO, the largest such group in the region, near the top of its class. Only 19 percent of accountable care organizations that entered the market in 2014 received rewards or "shared savings" payments. (Burling, 8/26)

Florida To Give Medicaid Insurers 7.7% Rate Increase

Elsewhere, officials in Texas are reviewing proposed cuts to Medicaid, but are likely to keep them. The move would affect therapy for children. In other Medicaid news, Iowa and Minnesota consider bids to run parts of their Medicaid programs, and Illinois cuts heroin addiction treatment in Medicaid from a bill to address the problem.

The Associated Press: Florida Gives Medicaid Insurers 7.7 Percent Rate Increase
Florida health officials said Wednesday they would give insurers a 7.7 percent rate increase in the fledgling Medicaid managed care program, in what has been a contentious battle between Gov. Rick Scott, the insurers and hospitals. The Republican governor lobbied hard to get federal approval for the statewide managed care program, which launched last year. He promised it would save money and improve health care for more than 3 million low-income and disabled Floridians. But now that the program seems in desperate need of additional funding, Scott has been blaming the insurance companies and hospitals. (Kennedy, 8/26)

Dallas Morning News: Texas Sticks By Plans To Deeply Cut Medicaid Therapy Rates
A lawsuit that sought to block deep cuts in what Medicaid pays for disabled children and poor elderly Texans’ therapies has delayed the rate changes for a month but otherwise forced no change in the state’s plans. On Wednesday morning, owners of several home health agencies who had challenged the reductions rejoiced after a Health and Human Services Commission lawyer announced in court that the agency will withdraw them. The cuts, averaging 18 percent to 20 percent across the board for full-service home health agencies, were to take effect Tuesday. ... Within a few hours, though, commission spokesman Bryan Black clarified that the reprieve was only temporary. The state will press ahead with the same deep cuts in fees for acute care therapy providers that it proposed this summer. (Garrett, 8/26)

The Texas Tribune: Texas To Move Forward With Cuts To Children's Therapy
The Texas Health and Human Services Commission will proceed with $100 million in cuts made by lawmakers to a therapy program for poor and disabled children, a spokesman said Wednesday afternoon. But the state will not implement the cuts Sept. 1 as planned, and will seek public comment at a hearing in the coming weeks. The Legislature called for slashing payments to speech, physical and occupational therapists who treat children through the federal-state Medicaid insurance program. Critics have said the move could jeopardize access to care for as many as 60,000 kids. (Walters, 8/26)

San Antonio Express-News: Texas Medicaid Officials Reviewing Proposed Cuts
The [Texas Medicaid] agency announced proposed rates in July that therapy providers said would severely reduce access for patients and force many providers to close. Parents of disabled children and therapy providers filed a lawsuit seeking to overturn the rates, and in depositions, the health agency included a memo suggesting it would phase in the reductions. A judge dismissed the lawsuit Wednesday after the health agency said it would abandon its original proposal and start the process over. Officials said they still intended to fully implement the cuts but would reconsider how the savings would be achieved. (Hawryluk, 8/26)

The Associated Press: Texas Says Medicaid Cuts Still Coming, Surprising Opponents
Texas health officials are postponing a $350 million cut in Medicaid payments to therapists after being pushed to the brink of legal action in state court. The Texas Health and Human Services Commission told a judge Wednesday that the agency now plans to start over and consider new rates. The about-face comes less than a week before the cuts were scheduled to take effect and after increasing bipartisan pressure. (Archer, 8/26)

Des Moines Register: Critics Call Iowa’s Medicaid Selection ‘Haphazard’
Three competitors say Iowa erred in its selection of four other companies to manage the state’s $4.2 billion annual Medicaid program and are seeking a review that could throw Gov. Terry Branstad’s privatization efforts into a legal quagmire. The companies – Aetna, Meridian and Iowa Total Care – filed written requests for reconsideration to the Iowa Department of Human Services in records obtained Wednesday by The Des Moines Register. (Clayworth, 8/26)

The Minneapolis Star-Tribune: Rival Insurers Oppose UCare's Request To Halt Medicaid, MinnesotaCare Overhaul
Rival health insurers want a Ramsey County judge to deny UCare’s bid for a second chance at business through a large public health insurance contract. In separate court filings supplied by health plans to the Star Tribune on Wednesday, Blue Plus, HealthPartners and Medica argue that the orderly transition for thousands of public health insurance enrollees would be threatened if a judge interferes with competitive bidding results announced last month by the state Department of Human Services (DHS). (Snowbeck, 8/26)

State Highlights: Okla. Plan To Increase Numbers Of Rural Doctors; Fla. Lawmaker Offers Plan For Hospitals To Track Nurses' Injuries

Health care stories are reported from Oklahoma, Florida, California and Illinois.

The Associated Press: OSU Announces Plan To Increase Rural Doctors In Oklahoma
Oklahoma State University officials on Wednesday announced a six-year, $3.8 million grant from the state's Tobacco Settlement Endowment Trust to help fund a medical residency program in mostly rural parts of the state. OSU President Burns Hargis said the money from the trust fund will be matched with $5.6 million in federal funding through the Oklahoma Health Care Authority. (Murphy, 8/26)

Health News Florida: Pressuring Hospitals About Injured Nurses
A proposal by Representative Hazel Rogers of Lauderdale Lakes would require hospitals to track injuries and form committees. The Florida Nurses Association has no formal position on the bill. But Jeanie Demshar, a director, says FNA members are complaining about the problem. (Ash, 8/26)

The Miami Herald: Miami Federal Jury Convicts Doctor, Therapists At Medicare Fraud Trial
Last year, the medical director of a Miami-Dade chain of mental health clinics and three therapists scored the equivalent of a legal tie when a federal jury deadlocked on charges accusing them of scheming to bilk Medicare out of millions of dollars. This week, they weren’t as fortunate: A new jury convicted Dr. Roger Rousseau, 73, of Miami, and the three state-licensed therapists, Doris Crabtree, 62, of Miami, Angela Salafia, 68, of Miami Beach, and Liliana Marks, 48, of Homestead, of conspiring to commit healthcare fraud. Rousseau, a psychiatrist, was also convicted of two related fraud offenses. (Weaver, 8/26)

Stateline: No Escaping Medical Co-Payments, Even In Prison
Not even going to prison spares patients from medical co-payments. In response to the rapidly rising cost of providing health care, states are increasingly authorizing the collection of fees from prisoners for medical services they receive while in state prisons or local jails. At least 38 states now do it, according to the Brennan Center for Justice at New York University School of Law and Stateline reporting. (Ollove, 8/26)

The Associated Press: California Tax Donations Lost In Bureaucracy
Every year when they do their taxes, Californians donate millions for charitable causes, but nearly $10 million of that money sat unspent in government accounts at the end of last year and some of the funding never reaches its intended target, according to a review by The Associated Press. ... Records show that $278,000 raised for asthma and lung disease research reverted to the state treasury because neither the Legislature nor the distributing agency put them to use. ...But in a dozen of the funds, state agencies tapped less than half the contributions available. Health agencies never used funding for a colorectal cancer prevention program, promoted by Erin Stennis, a Culver City woman who lost her husband to colon cancer in 2003. ... Not a single dime has been spent on cancer prevention. (Nirappil, 8/27)

Health News Florida: Grant Providing Free Mammograms For Uninsured Floridians
Hundreds of women in Florida will be able to get early screenings for breast cancer under a national program aimed at the uninsured. Three Florida facilities will receive the grants from the National Breast Cancer Foundation and Hungry Howie’s. Its “Love, Hope and Pizza” program awarded grants to more than 70 facilities around the country. In Tampa, a $25,00 grant helps Moffitt Cancer Center offer 200 low-income, uninsured women free mammograms and diagnostic breast care services. (Miller, 8/26)

News Service Of Florida: Judge Deciding Special-Needs Children Dispute
An administrative law judge is considering a challenge to the Florida Department of Health involving the eligibility of children for a state program that provides specialized medical care. Attorneys for children and the Department of Health filed proposed final orders Monday with Judge Darren Schwartz in the case, which focuses on a program known as the Children's Medical Services Network. (Menzel, 8/26)

News Service Of Florida: Med Tourism, Direct Primary Care Get Backing
Senate Health Policy Chairman Aaron Bean, R-Fernandina Beach, is looking to pitch Florida as a place for people to come for medical care. Bean on Tuesday filed a proposal (SB 178) that includes creating a program to market Florida as a "health care destination" -- a concept known as medical tourism. The bill, which will be considered during the 2016 legislative session, would create the program under Enterprise Florida, a public-private agency that seeks to boost economic development. (8/26)

The News-Sun: Possibility Of Student Medical Marijuana Patients 'New Territory' For County Schools
As Illinois moves closer to opening its first medical marijuana dispensaries, Lake County school districts are preparing for the possibility some of their students will be among the first patients allowed to use cannabis under state law. "We're going into some new territory, and we're going to have to work through this," said Ellen Correll, superintendent of Community Consolidated School District 46 in Grayslake. "We want to support anyone who needs it for a medical reason, but we have to be very careful with this in a school setting." (Zumbach, 8/26)

The Associated Press: US Judge Blasts Illinois For Not Making All Ordered Payments
A federal judge in Chicago scolded Illinois officials Wednesday for not fully complying with her order to pay social service providers in answer to a consent decree. U.S. District Judge Sharon Johnson Coleman broached the subject of holding the state in contempt of court. She ultimately ordered the Illinois state comptroller's office to determine within 48 hours which providers of service to developmentally disabled residents must be funded despite an ongoing budget impasse. (8/27)

Weekend Reading

Longer Looks: Helping Alzheimer's Patients; Getting Kids Dental Care; Birth Control Primer

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

Vox: I Thought I Could Fix My Alzheimer’s Patients. I Learned To Help Them Instead.
One of my grandmothers had had Alzheimer's, but it wasn't a disease I knew a great deal about. I wanted to learn more. I wanted to quit my tedious day job and help people instead of selling them things they didn't want or need. I took classes. There I learned quite a bit about Alzheimer's. I learned about plaques and tangles, the beta-amyloid protein, the possible causes, and all of the statistics. But neither my desire to help nor any class prepared me for the reality of working with actual patients. The first day I stepped onto the floor of a nursing home, when I transformed from a curious student to an actual caregiver, everything I thought about dementia, aging, friendship, and even the nature of death changed. (Nicholas Conley, 8/24)

The New York Times: Your Brain, Your Disease, Your Self
When does the deterioration of your brain rob you of your identity, and when does it not? Alzheimer’s, the neurodegenerative disease that erodes old memories and the ability to form new ones, has a reputation as a ruthless plunderer of selfhood. People with the disease may no longer seem like themselves. Neurodegenerative diseases that target the motor system, like amyotrophic lateral sclerosis, can lead to equally devastating consequences: difficulty moving, walking, speaking and eventually, swallowing and breathing. Yet they do not seem to threaten the fabric of selfhood in quite the same way. ... But maybe this conventional wisdom is wrong. (Nina Strohminger and Shaun Nichols, 8/21)

NPR: Kansas Town Takes Dental Care To School
A lack of preventive dental care for poor children is a national problem. Medicaid and the Children's Health Insurance Program, which cover children from low-income families, both pay for dental services. But fewer than half of children and teens enrolled in those programs received a preventive dental service last year, according to Stacey Chazin, a public health specialist with the Center for Health Care Strategies. (Andrea Muraskin, 8/21)

Aeon: When The Truth Hurts
More genetic information isn’t always better. Unlike for breast cancer, there are no clear preventative measures you can take if you find out you have a high risk of developing Parkinson’s or Alzheimer’s. If that knowledge is going to be a dark cloud over your life, you might reasonably prefer not to know. Information about biological relatives has helped to reunite families, but it has also torn them apart. When ‘George Doe’ (an alias) gave his parents the ‘gift’ of genetic testing, he found out that he had a half-brother that no one else in his family knew about. His ‘gift’ to his parents turned out to be a divorce. (Jess Whittlestone, 8/25)

Vox: 7 Facts Anyone Taking Birth Control Should Know
All birth control pills use hormones to prevent pregnancy. Some contain a hormone called progestin. Others contain two hormones, progestin and estrogen. All of them work by doing two things: They prevent women from ovulating, and they cause the cervical mucus to thicken, which makes it more difficult for a sperm to penetrate and make contact with an egg if the woman is ovulating. (Sarah Kliff, 8/25)

Medscape: Medscape Vaccine Acceptance Report: Where Do We Stand?
In the first seven months of 2015, measles was reported in 173 US residents from 24 states and the District of Columbia. Most of these cases (64%) were part of a large multistate outbreak linked to an amusement park in California. ... On the heels of the California outbreak, sporadic news reports claimed that more parents (including some who had previously refused vaccines) were seeking and accepting vaccination for their children, and Merck sales of the measles-mumps-rubella (MMR) vaccine soared. It is unknown, however, whether clinicians across the United States have experienced any real or lasting changes in vaccine acceptance among parents of children in primary care settings. Medscape conducted a survey of vaccine providers to find out. ... According to the respondents, recent measles outbreaks have induced more acceptance of the measles vaccine and, in fact, vaccines in general, in at least some parents. Parents' fears about their children contracting vaccine-preventable disease is the driving force behind this greater acceptance, although admission to school, daycare, and camp and increased knowledge about vaccines are contributing factors. (Yox, Scudder and Stokowski, 8/26)

Editorials And Opinions

Viewpoints: Insurance Mergers May Help Consumers; Paying For Health

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

The Wall Street Journal: A Healthy Side Of Insurer Mega-Mergers
Anthem’s proposed merger with Cigna following Aetna’s acquisition of Humana has set off alarms about lack of competition in the health-insurance industry. But policy makers should consider the potential benefits of industry consolidation. The greater efficiency and market power of larger insurance plans could lower prices for consumers by offsetting the bargaining power of health-care providers. (Victor R. Fuchs and Peter V. Lee, 8/26)

Arizona Republic: Republicans 0-2 In Bid To Block Medicaid
Republicans are now 0-2 in their crusade to block 250,000 low-income Arizonans from getting health-care coverage through the state’s Medicaid program. First, there was the Tea Party-led referendum, aimed at blocking the 2013 law that expanded Medicaid in Arizona. Vowing to “stop Obamacare,” organizers couldn’t even muster the 86,000 signatures needed to put the law on the ballot. So 36 Republican legislators sued then-Gov. Jan Brewer, saying she needed a two-thirds super majority to pass the law because it included a “tax” on hospitals. On Wednesday, Maricopa County Superior Court Judge Douglas Gerlach ruled that expansion of Arizona’s Medicaid program was legal, that the fee on hospitals “does not qualify as a tax” and thus only a majority vote was needed. (Laurie Roberts, 8/26)

Tampa Bay Times: Thanks Go To Americans For Prosperity
Americans for Prosperity, the conservative advocacy organization fueled by the billionaire Koch brothers, is performing a valuable public service for Tampa Bay voters. It is running a new TV and digital ad featuring the names and faces of Republican legislators from Tampa Bay who blocked the state from accepting billions in federal Medicaid expansion money to subsidize health coverage for low-income Floridians. That's very helpful, because voters should be reminded over and over exactly who voted to deny medical care to tens of thousands of Tampa Bay residents. (8/24)

Forbes: It's Time To Start Paying To Keep Patients Healthy
Back in 2009, President Obama spoke to the American Medical Association and said, “We need to bundle payments so you aren’t paid for every single treatment you offer a patient with a chronic condition like diabetes, but instead paid well for how you treat the overall disease.” That’s a great idea, and it could really improve health care. Unfortunately, the president’s signature reform did nothing to move in that direction. Now, as before, almost no one in the health care fields is actually paid to keep people healthy. (Robert Book, 8/26)

The New York Times: Let Fear Guide Early Stage Breast-Cancer Decisions
Two patients, I’ll call them Sara and Janine, both learned that they had ductal carcinoma in situ (D.C.I.S.), often referred to as Stage 0 breast cancer. Both underwent lumpectomies in their early 50s. Told that worrisome cells were found, both had another surgery. Then a third surgery was recommended. Sara decided she would rather live with the risk. Janine had the opposite response. “Let’s get this all out,” she said. Each is certain she made the best decision, but can both of them be right? (Lisa Rosenbaum, 8/27)

Los Angeles Times: Studies: States With Easier Access To Firearms Have Higher Suicide Rates
More than half of the nation’s 41,000 suicides each year are committed by people using guns, so it shouldn’t be all that surprising that two new, related studies find that states with stricter gun control laws tend to have both lower rates of suicides using guns, and lower overall rates of suicides. In other words, states where access to firearms is easier have higher rates of suicide. (Scott Martelle, 8/26)

JAMA Psychiatry: America’s Cannabis Experiment
Cannabis is widely used, psychoactive, and addictive. ... In the cannabis debate, does the science of consequences and addictive liability matter? Studies of humans and animals strongly indicate that cannabis changes the structure and function of the brain, and the propensity to cannabis addiction is heritable, which means that some are more vulnerable. On the other hand, it has been advocated that cannabis should be legalized or at least delisted as a schedule I drug. Nicotine and alcohol are regulated, taxed, and routinely enjoyed, providing a blueprint for the deregulation of other drugs that are supposedly less noxious. However, these licit addictive drugs lead to serious social and medical consequences. ... We should be careful in extrapolating long-term consequences of cannabis legalization. (David Goldman, 8/26)