KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Health Law Issues And Implementation

Boehner's Suit Challenging Obama's Health Law Orders Set To Be Argued In Court

Preliminary arguments are scheduled Thursday in a federal district court in Washington, D.C. The House of Representatives' lawsuit says that President Barack Obama overstepped his authority with executive orders implementing the Affordable Care Act. The Obama administration is asking the judge to throw out the case.

The Associated Press: First Hearing In House Lawsuit Over Obama Health Law
Obama administration attorneys are urging a federal judge to throw out an election-year lawsuit by House Republicans over the president's health care law. Attorneys for the House counter that their unusual suit deals with critically important issues related to the separation of powers and should be allowed to continue. (Werner, 5/28)

CNN: Boehner Touts His Lawsuit Challenging Obamacare
The House lawsuit zeroes in on two changes to Obamacare implemented by the administration. The brief filed on behalf of the House maintains the decision to waive the requirement that employers provide health care coverage isn't expressly called for in the law. It also argues that the $175 billion paid by the Treasury Department to insurers was "an unlawful giveaway" because Congress never approved the money. The brief cites the "power of the purse" assigned to Congress under the U.S. Constitution. (Walsh, 5/27)

The Fiscal Times: House Republicans Take Obamacare to Court
Obamacare is once again on its way to court. This week a federal district judge in Washington, D.C., is scheduled to consider a legal challenge from House Republicans who say that President Obama overstepped his executive authority in implementing major provisions of the health care law. (Ehley, 5/27)

Politico Pro: House’s Obamacare Lawsuit Faces First Legal Hurdle
The House of Representatives lawsuit challenging President Barack Obama for overstepping his executive authority in implementing the health care law faces its first key test Thursday, when a federal judge in Washington will consider whether the GOP lawmakers have a right to bring the case. (Mershon, 5/27)

Mid-Sized Businesses Seek Relief From Health Law Provision They Say Will Increase Costs

The Wall Street Journal reports that employer groups and insurers are pushing to keep these employers exempt from the health law's requirements -- scheduled to take effect Jan. 1, 2016 -- regarding what health plans must cover and how they are priced. The Journal also offers new takes on the so-called Cadillac tax.

The Wall Street Journal: Midsize Businesses Seek Relief From Federal Health Law
Employer groups and insurers are pushing to keep businesses with 51 to 100 workers exempt from a provision of the federal health law that they say could significantly increase their costs. For these midsize employers, the Affordable Care Act’s requirements for what health plans must cover—and how they are priced—are set to take effect on Jan. 1, 2016. (Radnofsky and Janofsky, 5/27)

The Wall Street Journal: West Coast Port Contract Has Employers Covering ‘Cadillac Tax’
The U.S. West Coast port labor contract ratified by dockworkers will require shipping companies and terminal operators to cover the tax on high-cost health plans beginning in 2018 under the Affordable Care Act, widely called the “Cadillac tax.” Health care benefits were an important part of the negotiations that culminated in an agreement in February and last week’s vote by the cargo handlers in favor a five-year contract that included wage increases, pension upgrades and substantial health care coverage. (Phillps, 5/27)

The Wall Street Journal CFO Report: How One Supermarket Chain Is Tackling Health-Care Costs
The “Cadillac Tax” isn’t the only reason executives are looking to shed health-care costs; low-margin businesses don’t have much choice but to arrest the increases and trim fat wherever they can. As CFO Journal reported Tuesday, finance executives are turning their attention to the controversial provision of the 2010 Affordable Care Act, which is scheduled to take effect in 2018 and penalizes companies whose benefits are deemed overly generous. But even modest grocers whose benefits won’t trigger a levy can’t afford to ignore the burgeoning costs of coverage. (Murphy, 5/27)

Supporters Of Subsidy Challenge Could Win Case But Lose Politically

If Republican backers of the challenge are successful, they will come under pressure to help the millions of Americans who would lose their federal subsidies and their coverage, reports The Associated Press. But Democrats could also face political consequences, if the administration prevails with the court.

The Associated Press: Health Law Court Case Winner Could Be Political Loser
The party that wins the impending Supreme Court decision on President Barack Obama's health care law could be the political loser. If the Republican-backed challenge to the law's subsidies for lower-earning Americans prevails, the GOP would have achieved a paramount goal of severely damaging "Obamacare." But Republican lawmakers would be pressured to help the millions of Americans who could suddenly find government-mandated medical coverage unaffordable — and they'd face blame from many voters if they failed to provide assistance. ... Should the Obama administration win, ... some say they'd have lost a potentially powerful cudgel for the 2016 campaigns. (Fram, 5/27)

Huffington Post: Here's How Many People In Each State May Not Be Able To Afford Insurance If The Supreme Court Rules Against Obamacare
The Supreme Court is expected to issue a decision in a major new lawsuit against Obamacare this June, and the health coverage for millions hangs in the balance. ... If the Supreme Court rules for the plaintiffs in this case, it would eliminate health insurance subsidies for 7.5 million low- and moderate-income people in those states, causing most of them to become uninsured when their premiums become unaffordable without financial assistance. Here's how the numbers break down in each state with a federally operated health insurance exchange. (Young, 5/28)

Meanwhile, the Supreme Court's "Hobby Lobby" decision may be aiding the White House in the most recent cases about the contraceptive mandate -

The Washington Post: White House Has Been Aided Recently By Ruling In Contraceptives Case
When a split Supreme Court last June exempted some companies from providing female employees with some contraceptive coverage because of the employers’ religious objections, Justice Ruth Bader Ginsburg sounded the alarm. The 5-to-4 decision in Burwell v. Hobby Lobby was one of “startling breadth,” Ginsburg wrote. ... But in what many expect to be the next major test of the Affordable Care Act’s contraceptive mandate — a challenge over whether the government has done enough to accommodate the objections of religiously affiliated nonprofit organizations such as universities, hospitals and charities — the Hobby Lobby decision so far has aided the Obama administration. (Barnes, 5/27)

White House Assails Fla. House Republicans' Opposition To Expanding Medicaid

The subject of expansion remains a hot topic as legislators prepare to try to find a budget compromise when they meet in special session next week. The issue is being watched closely by other states that also have not expanded the low-income health insurance program.

Miami Herald: Obama Spokesman Says Florida GOP Putting Politics Over Poor People In Medicaid Fight
President Obama's two-day stop in Miami has nothing to do with Florida's upcoming special legislative session forced by a disagreement over how to fund healthcare. But the White House couldn't avoid a reporter's question Wednesday about the president's opinion on the opposition from statehouse Republicans to expanding Medicaid under Obamacare. "We have demonstrated a willingness to work closely with state leaders to tailor solutions" to their residents, Press Secretary Josh Earnest said when asked about the issue in a conference call with Florida reporters. "The refusal of Republican officials in Florida to put the interests of their citizens ahead of their own political arguments is something that we've been disappointed by." (Mazzei, 5/27)

The Associated Press: Medicaid Expansion Rally Targets Uninsured In Hialeah
Medicaid expansion supporters are targeting Hialeah — the zip code that saw more health insurance sign-ups than any other in the country. Several other zip codes with the highest enrollment were also in South Florida. Health advocates say those enrollment numbers show the need to expand Medicaid to more than 800,000 Floridians who fall into a coverage gap. They make too much money to qualify for regular Medicaid but too little to qualify for a subsidy in the federal exchange. (5/28)

The Miami Herald: South Florida Lawmakers Discuss Medicaid Expansion At Health Forum
With a special legislative session set for next week, South Florida lawmakers, hospital representatives and health groups gathered Wednesday to discuss Medicaid expansion, the future of healthcare in Florida and a looming Supreme Court decision on subsidies. Sen. Rene Garcia, a Miami Republican who chairs the Senate healthcare budget committee, in a panel discussion with Sen. Anitere Flores, R-Miami, and Rep. David Richardson, D-Miami Beach, said a healthcare crisis still exists in Florida after the Legislature adjourned without passing a budget. About 850,000 Floridians fall into the healthcare “gap” created when Florida chose not to expand Medicaid. (Herrera, 5/27)

California Healthline: Is The Obama Administration Coercing States To Expand Medicaid -- Again?
The Obama administration once again has found itself on the defensive over the Affordable Care Act. Last month, Florida Gov. Rick Scott (R) filed a lawsuit alleging that the federal government is illegally attempting to force states to expand their Medicaid programs by not renewing funding measures for uncompensated care programs. ... The agency issued similar warnings to Kansas and Tennessee. Officials in Kansas and Texas are backing Florida's challenge. (Drost, 5/27)

Politico Pro: Texas Trying To Bolster Its Case With CMS For Hospital Funds
Texas hospitals are hoping the legislature’s move to boost their reimbursement rates in the 2016-2017 budget curries favor with CMS when it considers whether to renew separate pots of funding to cover uncompensated care. Lawmakers in Austin are set to approve their next budget just days after CMS preliminarily told Florida that it would significantly cut the amount of money going into that state’s uncompensated care program, the Low Income Pool. (Pradhan, 5/27)

The Charlotte Observer: Medicaid Boon Or Frankenstein Monster? Study Parses NC Reform
Medicaid reform is the $12 billion question in North Carolina, as legislators debate the best way to control costs for the federal-state insurance program for low-income residents, most of them children. A recent issue brief from the Wake Forest University law school offers a good overview of the options they’re considering, as well as what our state might learn from reform programs in Oregon and Ohio. (Helms, 5/27)


Blue Cross And Blue Shield Face Major Lawsuits Over Operations

The antitrust lawsuits allege that the 37 independently owned companies are functioning as an illegal cartel. Also in the news, the Japanese company that manufactures the endoscopes linked to a superbug outbreak is getting ready to settle an investigation into its product marketing.

The Wall Street Journal: Antitrust Lawsuits Target Blue Cross And Blue Shield
Blue Cross and Blue Shield health insurers cover about a third of Americans, through a national network that dates back decades. Now, antitrust lawsuits advancing in a federal court in Alabama allege that the 37 independently owned companies are functioning as an illegal cartel. A federal judicial panel has consolidated the claims against the insurers into two lawsuits that represent plaintiffs from around the country. One is on behalf of health-care providers and the other is for individual and small-employer customers. (Wilde Mathews, 5/27)

Los Angeles Times: Scope Maker Olympus Expects To Settle U.S. Claims Over Marketing
The manufacturer of endoscopes at the center of a string of deadly superbug outbreaks has set aside nearly $450 million for an expected settlement of a U.S. investigation into its marketing of medical products. Olympus Corp. of Japan did not disclose the details of what federal officials have been investigating other than saying the focus is on possible violations of laws that ban companies from paying kickbacks to doctors and other potential customers. (Petersen, 5/27)


Medicare Nurse Training Pilot Program Shows Promise

According to Politico Pro, advocates view this program as a means to help ease the nation's physician shortage. Meanwhile, The Associated Press reports that an AARP study concluded generic drug prices are on the rise.

The Associated Press: AARP Survey: Many Generic Medicine Prices Have Risen Sharply
Reversing a long-term trend, prices for more than one in four generic medicines widely used by older Americans increased in 2013, some very sharply, according to a survey by AARP. Generic drug prices on average are still falling, but the increases for certain classes of drugs may be a sign of more to come, the advocacy group says, because industry consolidation is reducing competition, manufacturing quality problems are causing shortages and the number of blockbuster brand-name medicines going off patent has fallen since a huge surge a few years ago. (Johnson, 5/28)

Campaign 2016

Kasich Defends Ohio's Medicaid Expansion, Decries Obamacare

In a CNN interview, the Ohio governor and GOP presidential hopeful said that bringing more federal money to Ohio to cover health care for the poor was a separate matter from supporting the federal health law -- which Kasich would repeal. And as Rick Santorum joins the crowded field of GOP presidential contenders, The Associated Press looks at the former Pennsylvania senator's positions.

CNN: Kasich Says He's Not An Obamacare Hypocrite
Would-be presidential candidate John Kasich, defended his expansion of Medicaid under the Affordable Care Act on Wednesday, while slamming President Barack Obama's signature law at the same time. Kasich, a second-term governor of Ohio, told CNN's Jake Tapper on "The Lead" that his support of a Medicaid expansion under the Affordable Care Act, or Obamacare, did not amount to support for the Obamacare itself. (LoBianco, 5/27)

The Associated Press: Where They Stand: Rick Santorum On Key Campaign Issues
A look at where former Pennsylvania Sen. Rick Santorum stands on some key issues as he opens his race for the Republican presidential nomination: ... Santorum supports making changes to the Medicare and Social Security programs to reduce costs. ... While in the Senate, Santorum was the leading supporter of a successful effort to ban a certain type of late-term abortion, sometimes referred to as partial-birth abortion. He supports an exemption to an abortion ban if the life of the mother is at stake. (Lucey, 5/27)

Public Health And Education

HIV Patients Should Be Treated Upon Diagnosis, Study Finds

People with the virus that causes AIDS should be put on antiretroviral drugs as soon as they learn they are infected, federal health officials said Wednesday. They put a halt to a clinical trial of early treatment more than a year early because they said the advantages were so evident.

The New York Times: H.I.V. Treatment Should Start At Diagnosis, U.S. Health Officials Say
People with H.I.V. should be put on antiretroviral drugs as soon as they learn they are infected, federal health officials said Wednesday as they announced that they were halting the largest ever clinical trial of early treatment because its benefits were already so clear. The study was stopped more than a year early because preliminary data already showed that those who got treatment immediately were 53 percent less likely to die during the trial or develop AIDS or a serious illness than those who waited. (McNeil Jr., 5/27)

The Associated Press: Don't Delay: Study Confirms Early Treatment Is Best For HIV
A major international study says HIV patients shouldn't delay in seeking treatment: Starting medication soon after diagnosis helps keep people healthy longer. People who started anti-AIDS drugs while their immune system was strong were far less likely to develop AIDS or other serious illnesses than if they waited until blood tests showed their immune system was starting to weaken, the U.S. National Institutes of Health announced Wednesday. (Neergaard, 4/27)

Patients, Family Members Turn Into Entrepreneurs, Activists

The Washington Post writes about the challenges of a man with early-onset dementia who has become an advocate for greater government support for research into Alzheimer's disease, and also about a woman who invented a clothing line for people who struggle with fine motor skills like her husband.

The Washington Post: More People With Alzheimer’s Are Becoming Activists — Which Brings Its Own Challenges
When Michael Ellenbogen calls for a more aggressive fight against Alzheimer’s disease, he speaks with passion that comes from experience. As someone who was diagnosed with early-onset dementia, Ellenbogen can convey firsthand the pain and frustration at what he sees as insufficient government support for research to find a cure or better treatments. But to some, Ellenbogen’s passion recently went too far. ... Ellenbogen, a former telecommunications manager, is one of a small but growing number of people with Alzheimer’s disease who are shaking off the stigma of the neurodegenerative illness to become public advocates in the campaign for a cure. But his experience shows the unusual challenges people with dementia sometimes face in the public arena. (Kunkle, 5/27)

The Washington Post: After Her Husband’s Parkinson’s Diagnosis, She Invented A Product To Improve His Life–And The Lives Of Millions
Maura Horton has always been her husband’s cheerleader. ... But after Don was diagnosed with Parkinson’s disease, a chronic and progressive movement disorder, in his 40’s and Maura found herself feeling helpless in the face of his degenerative disease’s affects. So she has stepped into a new role—one that she never imagined for herself: Founder and CEO of MagnaReady, which makes adaptive clothing for people who struggle with fine motor skills. People like her husband. (Tenety, 5/28)

State Watch

Appeals Court Sides With Doctors Who Challenged An Arksansas Abortion Ban

Also in the news from the states related to abortion and contraception news, the Alabama House approves new abortion-clinic regulations, a North Carolina Senate panel OKs a 72-hour waiting period for abortions and Wis. Gov. Scott Walker defends mandatory ultrasounds. Meanwhile, in Oregon, a Senate committee advanced legislation requiring private insurers to cover up to 12 months of birth control at a time.

The Associated Press: Abortion Ban Based On Heartbeat Rejected By Appeals Court
The 8th U.S. Circuit Court of Appeals sided with doctors who challenged the law, ruling that abortion restrictions must be based on a fetus' ability to live outside the womb, not the presence of a fetal heartbeat that can be detected weeks earlier. The court said that standard was established by previous U.S. Supreme Court rulings. (5/27)

The Associated Press: Bill Extending NC Abortion Wait Period Advances In Senate
A state Senate committee approved a proposal Wednesday for North Carolina to join the handful of states that require a 72-hour waiting period for abortions. The bill advanced by a Senate judiciary committee would extend the waiting period from the current 24 hours, which became law less than four years ago. The bill would also require that the procedure be performed by a specialist in obstetrics or gynecology. (Drew, 5/27)

The Associated Press: 12-Month Birth Control Bill Advances Out Of Senate Panel
An Oregon Senate committee has advanced legislation requiring private insurers to cover up to 12 months of birth control at a time. Currently, women can access a 30- or 90-day supply of contraception. Under the bill, private insurers would have to cover up to 12 months of contraception without requiring women to make multiple trips to the pharmacy. (5/27)

State Highlights: N.Y. State Assembly Backs Universal Health Coverage; Ohio Bill Would Let Doctors Prescribe STD Meds To Patients' Partners Without Exams

News outlets report on health issues from New York, Ohio, California, Florida, Wisconsin, Michigan, Colorado and Illinois.

The Associated Press: NY Assembly Votes For Universal Health Coverage
The New York Assembly voted 89-47 on Wednesday for legislation to establish publicly funded universal health coverage in a so-called single payer system. All New Yorkers could enroll. Backers said it would extend coverage to the uninsured and reduce rising costs by taking insurance companies and their costs out of the mix. (Virtanen, 5/27)

The Associated Press: Ohio Bill Would Allow Patients To Get STD Meds For Partners
A bill in Ohio seeks to expand access to treatment for certain sexually transmitted diseases by allowing doctors to prescribe medication to their patients' partners without examining them. Licensed health professionals in Ohio must first see patients before prescribing them antibiotics. But legislation before state lawmakers would create a limited exception for partners of patients who have been diagnosed with chlamydia, trichomoniasis or gonorrhea. The aim is to reduce infections. (5/27)

NPR: Supreme Court Says Locals Can Make Pill-Makers Pay For Drug Disposal
Many of us have old prescription drugs sitting around in medicine cabinets — so what's the best way to get rid of them? Some folks simply toss old pills in the garbage, or down the toilet. Both of those options can lead to medications in the ocean, bays or rivers. Three years ago Alameda County, across the bay from San Francisco, became the first county in the nation to require pharmaceutical manufacturers to pay for safe disposal of prescription drugs. Drug companies sued and lost in lower courts. Tuesday the U.S. Supreme Court refused to hear the case, meaning that drug makers will now need to pay for collection and disposal of unused drugs. (Shafer, 5/27)

Tampa Bay Times: House Offers Up Health Care Bills Aimed At Cutting Costs But They Could Also Ignite Turf Battles
After spending the last legislative session knocking down Senate proposals for expanding health care coverage while offering no alternative of their own, Florida House Republicans filed a series of bills Wednesday that attempt to take a rifle-shot approach to lowering the spiraling costs of health care in Florida. Many of the proposals are not new, and some have been passed by key committees in the state Senate, but all embrace the belief of many House leaders that the state must inject free-market competition into the health care marketplace to lower costs of health care before expanding access to the uninsured. Opponents, however, claim that many of the proposals just unleash turf battles within the health care industry that will not suppress costs. (Klas, 5/27)

Kaiser Health News: Asthma Visits Rising Among Kids In California ERs
Children in California increasingly are flocking to emergency rooms for treatment of asthma, despite millions of dollars spent on programs to control the disease. Statewide, the rates of ER visits for asthma symptoms rose by about 18 percent for California children ages 5 to 17 and by 6 percent for children under 5 between 2005 and 2012, according to a Kaiser Health News analysis of the latest available rates by county. (Ostrov, 5/28)

The Miami Herald: Florida Pledges To Protect Inmates With Mental Illness
Inmates with mental illnesses who were once confined around the clock to a cell block filled with feces, rotten food and insects — and sometimes allegedly beaten, tortured and starved by staff — should be treated more humanely under a landmark lawsuit settlement reached this week between the Florida Department of Corrections and a statewide disability advocacy group. The agreement could have far-reaching impact. It requires the state to overhaul the way it treats inmates with mental disorders at Dade Correctional Institution, which has the largest mental health facility in the state prison system. (Brown, 5/27)

The Associated Press: Budget Committee Approves Long-Term Care Changes
Republicans who control the [Wisconsin] Legislature's budget committee adopted most of Gov. Scott Walker's plan Wednesday to expand the Family Care program and incorporate elements of the IRIS program into it, pushing aside pleas from minority Democrats and advocates for the disabled to leave both programs alone. The GOP lawmakers tweaked Walker's plan in places, adding language that guarantees enrollees would still have a say in developing their care plans and would keep receiving state stipends to cover services they need just as IRIS provides. (Richmond, 5/27)

The Detroit Free Press: New Law Aims To Make Breast Cancer Testing More Effective
Women with dense breast tissue — the sort that can hide potentially deadly tumors from routine mammograms — must be notified in writing and encouraged to consider additional tests under a new state law that is effective Monday. While mammograms remain the gold standard for detecting breast tumors, they're less reliable in almost half of women with dense breast tissue. Dense or fibrous tissue shows up as splotches of white on a mammogram — so do tumors. (Erb, 5/28)

The Chicago Tribune: Illinois House Approves Heroin Treatment Measure
The Illinois House on Wednesday overwhelmingly pushed through a sweeping measure aimed at curbing heroin use and preventing overdose deaths by expanding specialized drug courts that focus on treatment. The measure also would require police departments and fire houses to stock opioid antidotes that could be used to counteract heroin overdoses. In addition, the state's Medicaid health care program for the poor would have to cover the cost of drug treatment programs. (Hellmann, 5/27)

Los Angeles Times: Pentagon Mistakenly Sends Live Anthrax To As Many As Nine States
The Army mistakenly sent live anthrax samples from a testing facility in Utah to commercial laboratories in as many as nine states, including California, as part of an effort to improve field testing for biological threats. Pentagon officials said the accidental transfer of the potentially deadly biological agent Bacillus anthracis, better known as anthrax, had not caused any known infections. (Hennigan,5/27)

Kaiser Health News: A Top Medical School Revamps Requirements — To Lure English Majors
You can’t tell by looking which med students at Mount Sinai were traditional pre-meds in college and which weren’t. And that’s exactly the point. Most of the class majored in biology or chemistry or some other “hard” science; crammed for the MCAT (the Medical College Admission Test) and did well at both. But a growing percentage came through Icahn School of Medicine at Mount Sinai’s “Hu-Med” program, which stands for Humanities in Medicine. They majored in things like English, history or medieval studies. And they didn’t even take the MCAT because Mount Sinai guaranteed them admission after their sophomore year of college. (Rovner, 5/27)

The Associated Press: CO Aims To Reduce Diabetes, Costs For Medicaid Clients
Colorado health officials are launching a diabetes prevention campaign for people covered by Medicaid, a state and federal health care program for low-income residents. The state Department of Public Health and Environment said Wednesday the program aims to reduce diabetes rates and health care costs by teaching people how to manage or avoid the condition. (5/27)

Weekend Reading

Longer Looks: Abortion Waiting Periods Drive Up Costs; The Backstory Of King V. Burwell

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

The Atlantic: Waiting Periods And The Rising Price Of Abortion
In recent weeks, Oklahoma tripled the length of its waiting period, becoming the fourth state with a 72-hour (three-day) delay. Florida enacted a 24-hour waiting period between two different appointments—one for an ultrasound and another for the procedure. Arkansas Governor Asa Hutchinson signed a two-day waiting-period bill last month—and simultaneously made the state the record-holder for the number of abortion restrictions passed in 2015 so far, advocates say. Tennessee passed a 48-hour wait just last week. Twenty-six states in all now impose these mandatory delays. ... The waiting periods’ most egregious toll, pro-choice advocates argue, is the amount of hassle and cost that comes with them, especially in the 11 states that require counseling before the wait begins. Abortions are already too expensive for some women to easily afford, they say. (Olga Khazan, 5/26)

Vox: The Accidental Case Against Obamacare
Now, the sales pitch is over. The Supreme Court will rule next month in King v. Burwell. The lawsuit will determine whether the Obama administration has the legal authority to dole out billions in tax subsidies to Obamacare enrollees. Unlike the last time conservatives took Obamacare to the Supreme Court — when the Republican party, major activists, and 26 attorneys general joined forces — the new challenge has a more surprising backstory for a big case. It is the result of the key players working loosely, overcoming lawsuit fatigue in conservative circles, pushing an argument that seems more technical than substantive, and even a bit of luck. (Sarah Kliff, 5/26)

The New York Times: Reducing My Dose, Unlocking My Muse
My version of screaming is writing, but for two years, from the time I started taking medication, until recently, the words were stuck inside me. I had to force them out. “I like the feeling of words doing as they want to do,” wrote Gertrude Stein, who died more than 40 years before Prozac hit the market. Same here. And with each cut in dosage (my most recent being 150 milligrams of bupropion down to 100), my words flow more easily, brain to fingers to screen. (Diana Spechler, 5/26)

Pacific Standard: Forever Young
When Billy Boy was born, I knew something was wrong. His eyes looked huge, and he had little control of his limbs. As the months passed and Billy did not develop as he should, doctors could find no single syndrome that matched up with his symptoms. Diagnosis: M.R. Mental retardation. Or intellectually disabled. Of the estimated 4.6 million Americans with some form of intellectual or developmental disability, more than 80 percent can live on their own with minimal assistance. The rest cannot live independently. It is in this latter group that Billy Boy will likely remain. (William Dettloff, 5/21)

The Atlantic: The Agony of Medical Bills
It shouldn’t take a Harvard expert in health policy to understand a doctor’s bill. But sometimes, it does. In August of last year, Liz was a medical student whose doctor found a lump on her tonsils. Her primary-care physician referred her to an in-network ear-nose-and-throat specialist. Liz, who asked to go by her first name, expected the usual $20 copay. Instead, she was charged $219.90—wrongly, in her view—for separate physician and facility fees. Under the terms of her plan, Liz says, she should not have been responsible for those charges. After a polite letter to her (“Thank you for your recent grievance...”), Anthem Blue Cross upheld the charges. (Olga Khazan, 5/21)

Public Source: Hepatitis C: Cost In The Way Of A Cure
Dee’s liver is scarred, but just a bit too healthy for her insurance to foot the bill for the new medications that cure hepatitis C more than 90 percent of the time. The Butler County resident, who suspects she got the virus getting a tattoo, was recently told by her doctor to come back in a year. John, a retired small-business owner from Washington County who was given blood in the early 1990s, was also denied the antivirals. ... These Pennsylvanians, who asked that their last names not be used because of the stigma surrounding hepatitis C, are among an estimated 205,000 in the state and 3.2 million in the country with the infectious blood-borne virus. The vast majority of those patients could be cured by new all-oral medications that came to market in late 2014, but because the costs and demand are so high, insurers are restricting who gets to be treated. (Stockton, 5/24)

Editorials And Opinions

Viewpoints: GOP Wrestles With Court Response; Mental Health And Poverty; Need For Nurses

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

USA Today: GOP Fills Obamacare Replacement With Poison Pills: Our View
In the next month or so, the Supreme Court will issue a ruling that could deeply wound or maybe even kill Obamacare — an outcome that would leave opponents cheering. But like the dog that catches the car he's been chasing, their excitement is likely to fade quickly if they're not ready with a replacement. Insurance markets would fall into chaos, causing at least 7.5 million people to lose the subsidies that make their premiums affordable, and Republicans would rightly be blamed. (5/27)

USA Today: Sen. Ron Johnson: My Plan Would Protect Patients
Americans went to the polls in November 2012 unaware that President Obama's assurance, "If you like your health care plan, you can keep it," would be crowned "Lie of the Year" by PolitiFact. A year later, millions of Americans lost health care plans they liked and could afford while also losing access to doctors they knew and trusted. ... Now that Obamacare has been implemented and Americans can judge both the good and the bad in it, it should be a central issue in the 2016 elections. ... A bill I have authored would protect patients — and give America an informed choice in the 2016 election between Obamacare and an affordable replacement. (Sen. Ron Johnson, R-Wis., 5/27)

Bloomberg View: GOP Split: What To Hate About Obamacare
Republicans dislike Obamacare: The party is unified on that issue. But they don't all dislike it for the same reasons, and their disagreements help explain their continued inability to figure out how to respond to a Supreme Court decision on the law that's expected by the end of June. (Ramesh Ponnuru, 5/28)

Bloomberg View: Republicans Would 'Save' Obamacare By Killing It
There's good reason for Congress to remodel some aspects of Obamacare. More than half of people who get health coverage through the insurance exchanges have high out-of-pocket costs, for example; 1 in 10 say they've gone without medical care because of the expense. Unfortunately, the congressional proposal getting attention at the moment -- from Republican Representative Tom Price of Georgia -- wouldn't fix these problems. And it would do away with parts of the law that are working well. (5/27)

Orlando Sentinel: Senate Plan Deserves Fair Hearing From House, Scott
In a good-faith effort to break the health-care policy deadlock that has immobilized Tallahassee, Florida Senate President Andy Gardiner unveiled a compromise Tuesday. The ink was barely dry when House Speaker Steve Crisafulli and Gov. Rick Scott rejected it. This is not leadership. Floridians deserve better. (5/28)

Huffington Post: Mental Illness Is A Much Bigger Problem For The Poor, New Study Shows
If you want to talk about inequality in America, you should be talking about mental illness -- and the ability of people to get treatment for it. On Thursday, the U.S. Centers for Disease Control and Prevention released a new study that demonstrates, in vivid terms, something that public health experts have known for a while: Mental health problems are far more common among the poor than the rich. ... The study, whose lead author is CDC epidemiologist Judith Weissman, does not address the issue of causality -- in other words, whether mental health problems lead to more economic hardship or whether economic hardship leads to more mental health problems. But most researchers believe the process works in both directions. (Jonathan Cohn, 5/28)

The New York Times: We Need More Nurses
Inadequate staffing is a nationwide problem, and with the exception of California, not a single state sets a minimum standard for hospital-wide nurse-to-patient ratios. Dozens of studies have found that the more patients assigned to a nurse, the higher the patients’ risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital — and the longer their hospital stay. According to one study, for every 100 surgical patients who die in hospitals where nurses are assigned four patients, 131 would die if they were assigned eight. (Alexandra Robbins, 5/28)

Forbes: Does it Pay For Hospitals To Provide Lousy Care?
I recently had surgery to relieve an impingement of my left hip. I suffered a complication of the procedure [and] the hospital where I received the surgery performed follow-up care to treat the complication. As I lay on the table receiving that second treatment I wondered – okay, I mainly wondered “are they really going to stick a needle there?!,” – but I also asked myself “how strange is it that when patients experience complications, hospitals are rewarded with money to perform additional procedures?” (Peter Ubel, 5/27)

The Philadelphia Inquirer: The Latest Weapon In Fight Against Superbugs
No, it’s not a new drug. It’s more policy. Antibiotic resistance is nothing new. The rogues gallery of superbugs continues to grow, with major concerns around antibiotic-resistant Salmonella Typhi, antibiotic-resistant gonorrhea, carbapenem-resistant Enterobacteriaceae (CRE), multidrug-resistant Tuberculosis, and Methicillin-resistant Staphylococcus aureus (MRSA). The CDC estimates that antibiotic-resistant bacteria cause two million illnesses and 23,000 deaths in the U.S. every year, and cost at least $20 billion in direct health care costs and up to $35 billion in lost productivity. (Marcelo H. Fernandez-Viña, 5/27)