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Summaries of health policy coverage from major news organizations.

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Political Cartoon: 'Deadly Drug'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Deadly Drug'" by Randy Bish, Pittsburgh Tribune-Review.

Here's today's health policy haiku:


ICD-10 Blues?
Unfortunately, there is
No code for that one.

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Health Law Issues And Implementation

Ky.'s Health Insurance Co-Op Set To Close, While Others Face Stiff Fiscal Challenges

The programs, set up by the health law in 23 states with initial federal backing, attracted large customer support in a number of areas but have suffered from financing problems. Five have either closed or plan to close at the end of the year.

The Washington Post: Financial Health Shaky At Many Obamacare Insurance Co-Ops
A new breed of health insurers created under the Affordable Care Act — representing one of the government’s most innovative attempts in decades to foster better coverage — is on shaky financial ground in many of the 23 states where the plans began. ... But in recent months, nearly half of the unorthodox start-ups have been told by federal regulators that their finances, enrollment or business model need to shape up. The Centers for Medicare and Medicaid Services (CMS), which oversees the health-care law, recently sent warning letters to 11 of the “co-ops,” as they’re known. The agency placed them on “enhanced oversight” or required them to produce a plan of “corrective action,” or both, according to federal figures not previously made public. Several have been notified in the past two weeks. (Goldstein, 10/10)

Lexington Herald-Leader: Kentucky Health Cooperative Going Out Of Business; 51,000 Insurance Customers Affected
The largest private provider of health insurance policies on Kynect, Kentucky's health insurance exchange, is going out of business. The Louisville-based Kentucky Health Cooperative Inc. announced Friday that it will end current memberships on Dec. 31 and will not add new members because of financial problems. It will not offer health insurance plans on Kynect when open enrollment for 2016 coverage starts on Nov. 1. The cooperative has about 51,000 members in all 120 Kentucky counties. (Brammer, 10/9)

The Louisville Courier-Journal: Health Coop Closes, 51,000 Need New Insurance
The Kentucky Health Cooperative, a nonprofit, government-subsidized insurance group aimed at offering consumers more choices in health coverage under the Affordable Care Act, will stop offering health plans at the end of this year. ... The state Cabinet for Health and Family Services said the state Department of Insurance will be working with customers to ensure coverage continues through this year when most of the cooperative policies expire. (Yetter, 10/9)

The Hill: Kentucky Nonprofit Health Insurer To Shut Down
The Department of Health and Human Services says that it recognizes that the low payments to insurers could have raised financial concerns for some insurers, and that as start-ups, not all co-ops would succeed. The Obama administration said when making the risk corridor announcement earlier this month that the low payments could cause “isolated solvency and liquidity challenges” for a small number of insurers. The Kentucky co-op is the fifth to close, following New York’s co-op last month. (Sullivan, 10/9)

Affordability Key Factor For Newly Insured Who Drop Their Health Law Coverage

Confusion about the health exchanges and insurance plans may also play a contributing role for those who decide to drop out, experts say. In related news, CBS News looks at the early impact of Obamacare on employers.

The New York Times: Insurance Dropouts Present A Challenge For Health Law
On Nov. 1, a new sign-up period for health insurance under the Affordable Care Act will begin .... But even as those efforts begin, the public insurance exchanges, also known as marketplaces, created by the law are facing another challenge: keeping the customers they already have. About 9.9 million people were enrolled in the federal and state marketplaces at the end of June, a drop of about 15 percent from the 11.7 million who the Obama administration said selected plans during the open enrollment period that ended in February. ... enrollment counselors, health care providers and consumers say cost is a factor. ... Experts also point to another factor behind dropping or losing coverage: confusion. Some who signed up for coverage this year lost it within months because they did not understand what information they had to supply or even that they were required to make monthly payments, according to counselors. (Goodnough, 10/11)

CBS News: Obamacare's Impact On Employment: An Early Look
Before the Affordable Care Act went into effect last year, critics claimed it would lead to job losses and cuts in employee hours. But how is it really playing out? The dire predictions have so far proved to be unfounded, according to a new research paper from Federal Reserve Bank of New York economist Maxim Pinkovskiy. (Picchi, 10/12)

Meanwhile, stronger privacy protections will be added to -

The Associated Press: US Boosts Privacy Protection On Health Insurance Website
Responding to criticism from civil liberties advocates, the Obama administration said Friday it has strengthened consumer privacy protections on the government's health insurance website as a new sign-up season nears. CEO Kevin Counihan said in a blog post that the web page will have a new 'privacy manager' that lets consumers opt out of embedded connections to third-party advertising, analytics and social media sites. (Alonso-Zaldivar, 10/9)

The Hill: ObamaCare Website Will Honor Do Not Track Requests is going to honor Do Not Track requests this enrollment season. The Center for Medicare and Medicaid Services, which runs the ObamaCare website, said that it would not track users who toggle a setting in their browser that sends the requests to the website. Websites are not currently required to honor Do Not Track requests, although every major browser gives users the option of turning on the setting. (McCabe, 10/9)

And in more news on the cost of health care in the U.S. -

The Fiscal Times: U.S. Still Behind Other Countries In Effective Health Spending
For years America’s gold-plated healthcare system has provided little bang for the buck. In 2013, the U.S. outspent 13 other high-income countries on medical care – including Australia, Canada, Germany and Great Britain. Yet the U.S. had comparatively poor health outcomes, including a shorter life expectancy and greater prevalence of chronic conditions, according to a new study by the Commonwealth Fund. (Pianin, 10/11)

New Numbers Indicate Enrollment Dip In Ark. Expanded Medicaid Program

Meanwhile, news outlets in Ohio and Alaska report on the impact of expansion efforts.

Arkansas Online: Medicaid's Enrollment Takes A Dip
The number of people approved for coverage under Arkansas' expanded Medicaid program rose to 263,387 in July before falling by almost 29,219 by the end of September, according to numbers released Friday by the state Department of Human Services. Meanwhile, the cost per person of the so-called private option, which covers most of the newly eligible adults, has increased from June to September by $6.89, from $484.94 to $491.83. The federal waiver authorizing the program sets a monthly cost target of $500.08 per enrollee for 2015. (Davis, 10/10)

KTOO: What Medicaid Expansion Means For This Juneau Family
Medicaid expansion has been available to Alaskans for over a month, and 93 people in the capital city have enrolled. 263 in all of Southeast. It’s providing coverage for the uninsured. But it’s also offering increased care for those who qualify with Indian Health Service. For one Juneau man, that means having options to treat alcohol addiction. (Jenkins, 10/11)

Audit Finds Md. Exchange Failed To Protect Customers' Personal Information

The state audit also criticized other aspects of the exchange, including how contracts were awarded and a wide range of fiscal issues.

The Baltimore Sun: State Audit Criticizes Health Exchange Procurement Practices
A state legislative audit sharply criticized Maryland health exchange officials for a wide range of fiscal failures, including how it awarded contracts to companies building the state's initially troubled online insurance marketplace. The rollout of the Maryland Health Connection in 2013 was one of the worst under President Barack Obama's landmark health care reform initiative. The state ended up cutting ties with the initial contractor and replacing the technology behind the exchange. (McDaniels and Cox, 10/9)

Capitol Hill Watch

Republicans Continue To Lobby For A 'Speaker Ryan'

House members praised Paul Ryan during the Sunday political talk shows, saying he has the support of both the establishment and hard-line factions of party. But so far the Wisconsin lawmaker has resisted the calls to run for the top post.

The Wall Street Journal: Paul Ryan Seen As Able To Bridge The GOP Gap
Still, several influential conservatives say Mr. Ryan, with admirers among both establishment types and hard-liners in the caucus, is the closest thing to a consensus candidate and would draw more GOP votes in the conference than anyone, including Mr. McCarthy. Mr. Ryan, 45 years old, first came to prominence in the years following the 2006 elections that drove Republicans out of power in the House. Dismayed by the party leadership’s cautious approach to changes in fiscal policy, Mr. Ryan began circulating a set of far-reaching ideas for an overhaul of federal budget, tax and entitlement programs. These proposals made him a favorite target of liberal Democrats, particularly his calls to revamp Medicare, which they argue would slash benefits. (McKinnon, 10/11)

Politico: What It Would Take For Ryan To Run
Paul Ryan has made it abundantly clear he does not want to be speaker of the House. He enjoys the wonkery that comes with being Ways and Means chairman and believes he'd lose that as ringleader of the unwieldy Republican Conference. But there’s one remote scenario, people close to him say, in which Ryan would consider abandoning his long-laid career plans and go for the speakership: if he was the true consensus choice of the party. That means no opposition, no sniping, no acceding to demands in exchange for support. (Sherman, 10/12)

House Panel Passes Bill To Strip Key Mandates From Health Law, Funding From Planned Parenthood

The full House will vote next. Republicans are using the budgetary tool of reconciliation to fast track the legislation through both chambers of Congress to the president's desk. President Barack Obama is all-but-certain to veto the measure.

The Associated Press: House Bill Targets Health Law, Planned Parenthood Funds
The House Budget Committee approved Republican legislation Friday that would scuttle President Barack Obama's health care law, block federal payments to Planned Parenthood — and likely lead to a presidential veto. The measure is the latest of many GOP measures that have been aimed at both targets but that Democrats have managed to derail in the Senate. This time, Republicans are using a special process that would prevent Democratic senators from using filibusters, or procedural delays, to kill the measure. That means there's a strong chance the legislation will reach Obama — who would be certain to veto it. Republicans are pushing it anyway as a vehicle to highlight their views to conservatives ahead of next year's presidential and congressional elections. (Fram, 10/9)

And on the lobbying front -

The New York Times: Big Tobacco’s Staunch Friend In Washington: U.S. Chamber Of Commerce
Since taking over in 1997, [Thomas J.] Donohue has transformed the chamber into a powerful lobbying force, an evolution most starkly epitomized by its aggressive advocacy for tobacco. While the organization represents a variety of industries, its strategy has been a boon for cigarette makers, which have relied heavily on the chamber to push their agenda at home and abroad. (Hakim, 10/9)


Flat Social Security Benefits, Medicare Premium Boosts Mean Pricey 2016 For Some

A 52 percent increase in Medicare premiums for one-third of beneficiaries could lead to a protracted battle to lessen the sting of higher rates. Elsewhere, the Tampa Bay Times looks at open enrollment in the program, and more doctors in Oregon are shunning patients who have traditional Medicare plans.

Marketplace: Rising Medicare Premiums Mean A Big Increase For Some
Two things tend to happen every year. First, Social Security benefits rise. Second, premiums for Medicare Part B — which covers inpatient treatment, the cost of doctors and certain drugs — also rise. But what makes this such an unusual year is that Social Security benefits are flat for 2016. (Gorenstein, 10/9)

Pittsburgh Post-Gazette: Battle Begins Against Possible Rise In Medicare Premiums
A tight year for Medicare could force millions of seniors to pay at least $650 more for the public insurance in 2016, sparking a likely showdown between policymakers and activist groups. AARP promises to fight the 52 percent increase in premiums forecast for nearly a third of Medicare Part B beneficiaries, including higher-income families and those enrolling in the program for the first time. All enrollees could see yearly deductibles climb from $147 to $223 under Part B, which covers outpatient services, emergency visits and other medical care for more than 47 million elderly and Americans with disabilities. (Smeltz, 10/11)

Oregonian: Medicare 2015: More Doctors Rejecting Original Medicare
C.J. Reynolds is grateful for the care she's received at Oregon Health & Science University. But any time she's referred outside the system, the 69-year-old Portlander crosses her fingers. "I've had a heck of a time if I go outside OHSU looking for any kind of specialist, finding a doctor who will take standard Medicare, and that's a real problem," Reynolds said. ... Nationwide, 91 percent of non-pediatric doctors say they take new Medicare patients, according to an analysis of 2012 government survey data by the Kaiser Family Foundation, a Washington, D.C.-based policy research organization. Only 2 percent of seniors reported problems finding a provider when they needed one. ... But Oregon doctors accepted Medicare at the lowest rate of any state in the Kaiser survey: 79 percent. (Hunsberger, 10/10)

Campaign 2016

Democrats LIkely To Highlight Positions On Drug Prices During First Debate

Sen. Bernie Sanders also says that more tax money is needed to tackle the nation's problems. Meanwhile, a onetime Democratic vice presidential nominee, former Connecticut Sen. Joe Lieberman, is returning to the public arena to prod both parties to action.

The New York Times: A Likely Debate Highlight: Democrats’ Distance From Obama
Mr. Obama’s legacy and how much a Democratic successor should embrace it will hover over the debate, even as Hillary Rodham Clinton, Senator Bernie Sanders and the other Democratic candidates put forth their specific policy proposals and promises. ... Last week, she said she could not support Mr. Obama’s signature trade pact, the Trans Pacific Partnership, which she had championed as secretary of state and which Mr. Sanders had come out forcefully against. She has also proposed doing away with the so-called Cadillac tax on certain health care plans, aligning herself with labor unions on dismantling a key part of Mr. Obama’s Affordable Care Act. Mr. Sanders has also taken aim at the law, saying it does not go far enough to make health insurance affordable for many Americans. (Chozick, 10/11)

The Hill: Sanders Slams Drug Company CEO Over Prices
Sen. Bernie Sanders (I-Vt.) is calling out a much-maligned pharmaceutical company for holding patients “hostage” with the price of its drug. Turing Pharmaceuticals and its CEO Martin Shkreli have faced a wave of negative publicity after news broke last month that it raised the price of drug to treat a life-threatening infection from $13.50 to $750 overnight. (Sullivan, 10/9)

CNN: Bernie Sanders: Raise Taxes To Fund Pricey Proposals
Vermont Sen. Bernie Sanders says the federal budget deficit is a "serious problem" -- but he's not backing away from potentially pricey policy proposals. In an interview with NBC's Chuck Todd set to air Sunday on "Meet the Press," the Democratic presidential contender said he'd pay for his plans -- including $1 trillion for infrastructure and a "Medicare for all" health insurance system -- through higher taxes on wealthy Americans and corporations that keep profits outside the country. (Bradner, 10/11)

The Wall Street Journal: For Lieberman, A Return To Spotlight In Campaign Season
Mr. Lieberman will co-lead a forum Monday for presidential candidates in Manchester. Five Republicans—including front-runner Donald Trump—and three Democrats will be on hand for a rare joint appearance by candidates of both major parties in New Hampshire. ... Nearly 2,000 New Hampshire voters registered to attend the event, and every candidate who has declared they are running for president was invited to attend, a No Labels spokesman said. The group hopes to get pledges from the candidates to adopt some of the goals of No Labels, including balancing the federal budget by 2030, ensuring the survival of Social Security and Medicare for another 75 years and creating 25 million jobs over the next decade. (De Avila and Haddon, 10/11)

State Watch

Conn. Gov. Malloy Makes Concession In Political Fight Over Hospital Funding

The governor announced plans to restore $14.1 million in funding to six of the state's smaller hospitals. The battle, which involves a Malloy administration proposal to cut Medicaid funding for hospitals, could likely lead to legal action. Meanwhile, in other hospital news, Ohio's West Chester Hospital, which is owned by UC Health, agreed to a $4.1 million fraud settlement.

The Connecticut Mirror: Malloy To Restore Funding For Smaller Hospitals
The administration of Gov. Dannel P. Malloy is making a strategic concession in the bitter political fight over hospital funding cuts by restoring $14.1 million to a half-dozen of the state’s smaller hospitals. The administration is shifting funds originally budgeted for the larger hospital groups to six small independent hospitals: Bristol, Day Kimball, Griffin, Charlotte Hungerford, Johnson Memorial and Milford. (Pazniokas, 10/9)

The Associated Press: Connecticut Hospitals Not Ruling Out Possible Legal Action
Connecticut's hospitals, embroiled in a battle with Gov. Dannel P. Malloy over cuts in Medicaid payments, are not ruling out a path taken by their counterparts in New Hampshire: possible legal action. That state's hospital association decided in 2011 to sue New Hampshire after its Republican-controlled Legislature cut Medicaid funding by more than $130 million, but retained a tax on hospitals that was supposed to help the state gain matching federal money to pay for health care for the poor. (Haigh, 10/11)

The Cincinnati Enquirer: UC Health To Pay $4.1 Million In Fraud Settlement
West Chester Hospital and its parent company, UC Health, agreed to pay $4.1 million to settle allegations that Medicare and Medicaid were billed for medically unnecessary spine surgeries, and the doctor who performed the surgeries may have fled the country, according to the Justice Department. This settlement resolves allegations that West Chester Hospital submitted claims to Medicare and Medicaid for the spine surgeries performed between 2009 and 2013 by Dr. Abubakar Atiq Durrani, according to a press release. (Knight, 10/10)

In Mass., Gov. Baker empowers hospitals to take action against heroin epidemic by allowing facilities to hold addicts for three days -

The Boston Globe: Baker Would Give Hospitals The Power To Hold Addicts
Governor Charlie Baker, staring down a brutal opioid epidemic, wants to give hospitals new power to force treatment on substance abusers who pose a danger to themselves or others. Administration officials say the governor plans to file legislation this week giving hospitals the authority to hold addicts against their will for three days, evaluate them, and decide whether to seek legal permission for substantially longer commitments. (Scharfenberg, 10/11)

In other state-level hospital news -

The Associated Press: Feds Threaten To Cut Funding To Psychiatric Hospital 3 Times
Federal regulators said conditions at Washington state's largest psychiatric hospital were so dangerous for patients that they threatened to cut millions of dollars in funding three times this year. The state agency that oversees Western State Hospital said Thursday that they are addressing the problems, but they need more money and staff to make the facility safe. (Bellisle, 10/11)

The Des Moines Register: Branstad's Mental Hospital Closures Debated In Court
Lawyers for Gov. Terry Branstad and his critics argued in court Thursday over whether he broke the law by using his line item veto authority to effectively shutter two state mental hospitals. Branstad in July vetoed a bipartisan compromise plan that would have reversed his closure of the mental institution at Mount Pleasant and would have temporarily kept open a similar facility at Clarinda. (Leys, 10/9)

Iowa Signs Medicaid Contracts With Four National Companies To Manage The Massive Program

The companies will take control of the state program Jan. 1.

Des Moines Register: Iowa Signs Medicaid Contracts With Private Managers
Iowa officials announced Friday that they have signed contracts with four national companies to manage the state’s massive Medicaid program. However, that is not the last step before the companies could take control of the program as planned Jan. 1. ... The contracts were supposed to be signed several weeks ago, but state administrators have said it took a bit longer than expected to work out the details. Critics say the state is moving too quickly to make the change. ... Skeptics fear the switch will lead to cuts in services for the 560,000 poor or disabled Iowans who use the $4.2 billion health care program, which is jointly financed by the state and federal governments. (Leys, 10/9)

Meanwhile, Rep. Raul Grijalva, D-Ariz., urges federal officials to reject Arizona Gov. Doug Ducey's plan to tighten Medicaid eligibility and make other changes as part of an effort to reform the program -

Arizona Repubic: Rep. Raul Grijalva To Feds: Reject Gov. Doug Ducey's Medicaid Plan
U.S. Rep. Raul Grijalva urged the Centers for Medicare and Medicaid Services to reject Gov. Doug Ducey’s plan to tighten eligibility and impose cost-sharing requirements for able-bodied adults enrolled in Arizona’s Medicaid program. The Tucson Democrat said in a letter to the federal agency that Arizona’s public input was “woefully insufficient” for a sweeping reform plan that would impose work requirements, co-payments and a five-year eligibility limit on more than 300,000 able-bodied adults. (Alltucker, 10/9)

Calif. Gov. Brown Signs Array Of Laws Indicating What's Next On His To-Do List

The state measures Gov. Jerry Brown signed include one that cements the state's expansion of public health care to children who are in the country illegally as well as another that requires crisis pregnancy centers that discourage women from getting abortions to provide information about abortions and other services. He rejected a bill that would have allowed terminally ill patients who have exhausted all other options to access experimental drugs, products or devices that have not yet been OK'd by the Food and Drug Administration.

Los Angeles Times: Gov. Jerry Brown Targets His Next Priorities As He Decides On Final Slate Of Bills
Sprinkled throughout his signing statements and veto messages were clear indications of his next priorities. Brown emphasized his wish to find firmer financial footing for public healthcare; ease voter-approved restrictions on the cost of water in the face of an unrelenting drought; and begin a wide-ranging examination of the state's criminal justice system. ... The governor needled lawmakers on the impasse over a healthcare tax while vetoing legislation such as proposed expansions of Medi-Cal benefits, saying they would be unwise "until the fiscal outlook … is stabilized." The tax is a key issue for next year, when California faces the loss of $1 billion in funding from Washington unless lawmakers agree to broaden a levy on healthcare plans so it complies with federal law. (Mason and Megerian, 10/12)

The Associated Press: California Governor Signs Crisis Pregnancy Centers Bill
Crisis pregnancy centers that discourage women from getting abortions in California will be required to provide information about abortions and other services under legislation Gov. Jerry Brown has approved. The measure imposes the first such statewide rule, after local communities around the country have tried similar efforts. (Williams, 10/9)

The Sacramento Bee: Health Clinics Run By Anti-Abortion Groups Sue Attorney General Over AB 775
Reproductive health clinics run by abortion opponents moved immediately to head off enforcement of a bill signed Friday by Gov. Jerry Brown that would require the clinics to inform patients that abortion services are available elsewhere. On Saturday in Sacramento federal court, religiously affiliated clinics in Marysville and Redding that don’t offer abortions sued California Attorney General Kamala Harris, a sponsor of the new law, asking for an injunction preventing it from taking effect Jan. 1. (Walsh, 10/11)

The San Jose Mercury News: 'Right To Try' Bill: Brown Rejects Proposal To Let Terminal Patients Use Unapproved Drugs And Devices
Despite his landmark decision last week to grant terminally ill patients the right to end their lives with a doctor's help, Gov. Jerry Brown took a different course on Sunday and rejected Assembly Bill 159, the so-called "Right To Try'' bill. The latter measure sought to allow terminally ill patients who have exhausted all other options to access experimental drugs, products or devices that have not yet been approved by the U.S. Food and Drug Administration. (Seipel, 10/11)

State Highlights: Texas Doctors, Insurers Blame Each Other In Balance Billing Battle; In Va., A Push To Drop Certificate-Of-Need Rule For Hospital Construction

News outlets report on health issues in Texas, Virginia, Colorado, California, Maryland, Kansas, Ohio, North Carolina and Florida.

The San Antonio Express News: Texas Doctors, Insurers Taking ‘Balance Billing’ Fight Public
Faced with increasing public anger over surprise medical bills, Texas doctors and health insurance companies are turning to a new tactic to try to help shape conversations over potential future regulations: blaming each other. In a series of news releases and statements this week, two of the most powerful groups in the state medical community ended what had amounted to a public truce over so-called “balance billing.” (Rosenthal, 10/11)

The Associated Press: Conservative Groups Target Health Care Regulations
Last year, tea party and conservative groups helped squash Democratic Gov. Terry McAuliffe’s plans to expand Medicaid, derailing the governor’s top legislative priority for the foreseeable future. Now they want Virginia to drop a decades-old requirement that Virginia hospitals get approval before proceeding with major construction projects or equipment purchases. Supporters say the law, known as certificate of public need, hold down health care costs by avoiding unnecessary duplication of services. But conservative groups say the law is to limit competition to the advantage of large hospitals and limits customer choice. (Suderman, 10/9)

The Denver Post: Single-Payer Initiative Would Target Health Insurance Exchange
Colorado voters could be asked to make a choice on next year's ballot: Would you trust an elected state board to govern your medical needs more than private insurers and Obamacare? Initiative 20 would unwind Connect for Health Colorado, the insurance exchange that complies with the Affordable Care Act, or Obamacare. Instead of buying private insurance, Coloradans would pay another 10 percent in premium taxes to cover their medical care. (Bunch, 10/12)

Los Angeles Times: How The UC System Is Making Patents Pay Off
As they consider ways to improve university revenues, campus administrators point to the life-saving hepatitis B vaccine, the nicotine patch that helps smokers quit their habit and the tasty Camarosa strawberry. Those patented innovations, all pioneered at the University of California, have earned the school system, and the faculty who developed them, more than $500 million. (Gordon, 10/10)

The Washington Post: Right-To-Die Advocates Pushing Hard For Legislation In Maryland In 2016
Advocates of assisted suicide are significantly expanding their efforts to build support in Maryland for broader end-of-life options, hopeful that a recent victory in California will provide new momentum for legislation that failed to get out of committee in Annapolis this year. Across the state, organizers are meeting with faith-based communities; inviting small groups to watch the documentary “How to Die in Oregon,” about that state’s assisted-suicide law; and serving coffee and doughnuts at “house parties” that seek support for assisted-suicide proposals and offer information about health-care options when people are severely injured or become terminally ill. (Wiggins, 10/10)

KQED: Education Push To Help Doctors Field Patients’ Assisted-Death Requests
Now that California has legalized physician-assisted suicide, advocacy groups are planning statewide education campaigns so doctors know what to do when patients ask for lethal medication to end their lives. One of the first stops for doctors new to the practice is a doctor-to-doctor toll-free helpline. It’s staffed by physicians from states where the practice is legal, who have experience writing prescriptions for lethal medication. (Dembosky, 10/12)

The Texas Tribune: State Supreme Court Will Review Tax On "Small Tobacco"
The Texas Supreme Court agreed Friday morning to review a state tax on small cigarette manufacturers, known collectively as "Small Tobacco." The case centers on House Bill 3536, passed two years ago, which imposes a 55-cent fee on each pack of cigarettes produced by Small Tobacco. State Rep. John Otto, who wrote the bill, said at the time his goal was to “level the playing field” — tax smaller cigarette manufacturers in the same way Big Tobacco is taxed. (Rudner, 10/9)

The Kansas Health Institute News Service: Annual KDHE Report Shows Progress On Black Infant Mortality Rate
A statistical summary published every year by the Kansas Department of Health and Environment shows a glimmer of progress last year on a long-standing health disparity between black and white Kansans: the death rate for babies in their first year of life. For more than 20 years, black babies have died at a much higher rate than white babies in Kansas. Some years, the difference has been three-fold. But the 2014 Summary of Vital Statistics from KDHE shows a drop of almost one-third in the black infant mortality rate, from 15.3 per 1,000 live births in 2013 down to 10.3 deaths per 1,000 live births in 2014. (Thompson, 10/9)

Reuters: Court Battle Over Amish Girl's Cancer Treatment Ends
An Ohio judge on Friday formally ended a court effort to force chemotherapy on an Amish girl whose parents had defied a hospital over her treatment for leukemia, according to a ruling released on Friday. Medina County Probate and Juvenile Judge Kevin Dunn terminated the medical guardianship for the girl, ending a legal battle over the limits on parents' rights to make medical decisions. A court-appointed medical guardian had already given up on forcing the girl to resume chemotherapy after her family left the country for a while in 2013 to pursue alternative treatments that the family said improved the girl's condition. (Palmer, 10/9)

North Carolina Health News: Rural Recovery Center Gets Federal Dollars To Save Heroin Users In WNC
Heroin users are 20-something professionals. They’re somebody’s grandma. A community-based network of concerned officials and citizens in Franklin, the county seat of Macon County in the rural southwestern corner of the state, is aiming to get people to the treatment they need. On Set.17, Full Circle Recovery Center was awarded a federal Health Resources and Services Administration Rural Opioid Overdose Reversal grant to support this network, called the Macon Overdose Prevention Coalition. (Sisk, 10/9)

The Miami Herald: Cigna Agrees To Change HIV Mail-Order Med Rule
People living with HIV/AIDS and insured through Cigna, one of the nation’s largest health insurers, will no longer be required to buy their antiretroviral medications by mail order under a legal settlement reached in U.S. District Court in Fort Lauderdale and announced Friday. Cigna agreed to change its policy after a nonprofit patient advocacy group, Consumer Watchdog, filed suit in April claiming that the health insurer’s mail-order-only policy risked the health and privacy of its patients. Lack of choice, the lawsuit claimed, equated to discrimination. (Chang, 10/9)

The Miami Herald: UM Organ Bank Director Steps Down Despite Record Organ Donations
The University of Miami is searching for a new leader for South Florida’s only organ bank after the executive director stepped down over differences with university administrators — days before federal regulators conducted an unannounced inspection. Michael Goldstein, a surgeon hired in February 2014 to lead the kidney transplant program at the Miami Transplant Institute and to serve as director of the Life Alliance Organ Recovery Agency, left the university Sept. 25 “to pursue other opportunities,” according to a UM spokesman. (Chang, 10/9)

The Associated Press: Miami Doctor Charged In $20M Medicare Fraud
A Miami doctor is facing two federal fraud conspiracy charges for his alleged role in a $20 million Medicare fraud scheme run by a health care company. Dr. Henry Lora is scheduled to enter a plea Oct. 21 to the charges, which carry a combined 25-year maximum prison sentence. Lora is free on $600,000 bail. His attorney didn't immediately respond to an email seeking comment. (10/11)

Editorials And Opinions

Viewpoints: Rising Medicare Premiums; Fairness For Entitlements; High-Priced Stem Cell Therapy

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

The New York Times: The Unlucky Millions Paying More For Medicare
A quirk in the laws governing Medicare and Social Security will expose millions of Americans to a staggering 50 percent increase in their premiums for the part of Medicare that covers doctors’ bills, known as Medicare Part B. It is imperative that Congress pass legislation to protect low- and middle-income people who cannot pay that much. (10/10)

The Washington Post: A Fairer Approach To Fiscal Reform
Benefits for older Americans — especially through Social Security and Medicare — account for the largest part of federal spending today and for the lion’s share of the spending growth that will occur in coming decades without changes in policies. ... cuts in Social Security or Medicare benefits, or increases in the taxes used to finance those programs, will almost certainly be needed to put federal debt on a sustainable path. ... To avoid significant across-the-board cuts in Social Security and Medicare benefits, some of the standard arrows in reformers’ quivers should be a last rather than a first resort. For example, an increase in the eligibility age for full retirement benefits in Social Security would ... be especially harmful for lower-income people .... Instead, we should focus on reducing Social Security and Medicare benefits for high-income beneficiaries and raising payroll taxes on workers with high earnings. (Douglas Elmendorf, 10/11)

Los Angeles Times: Sky-High Price Of New Stem Cell Therapies Is A Growing Concern
The public uproar about high drug prices has focused on outlandish cases such as single pills jacked up in price by 5,000%, miracle cures marketed for tens of thousands of dollars per treatment. But how will people feel when they're confronted with treatments that are even more astronomically expensive? That's certain to become a growing concern at California's incubator of some of the most advanced and potentially costly medical therapies under development. Biotech companies have launched late-stage clinical trials that could lead to federal approval of two marketable treatments backed by CIRM, the state's $6-billion stem cell program. (Michael Hiltzik, 10/9)

The Washington Post: How Hillary Clinton Panders
The question is not whether [Democratic presidential candidate Hillary Clinton is] pandering but how negative the real-world consequences of her pandering will be. ... The Cadillac tax is perhaps the most potent cost-containment mechanism in Obamacare, which is why unions don’t like it: They want to keep their handsome benefits packages, even if it means, in effect, using public subsidies to drive up unnecessary health-care costs. Even though even liberal economists back the Cadillac tax, Clinton surrendered to union pressure last month, saying that she favors repealing it. But she added a big caveat: Congress would have to find some way to replace the revenue that the tax would raise, which is necessary to fund Obamacare’s health-coverage expansion. (Stephen Stromberg, 10/11)

USA Today: Hillary Clinton Boosts Her Doubters: Our View
[Hillary Clinton] has decided to oppose the Trans-Pacific Partnership, or TPP, trade pact. She's against the Keystone oil pipeline. And she wants to repeal the so-called Cadillac tax on high-end health insurance plans. These initiatives are all opposed by vocal and well-organized constituencies, generally ones that reside in the liberal wing of the Democratic Party. But all are economically beneficial .... As the architect of the ill-fated health care reform proposal offered during her husband’s administration, she is well aware that the Cadillac tax is widely supported by health care economists as a way of controlling costs. The positions she has taken are the easy way out. (10/11)

USA Today: Howard Dean: Hillary Fights For Working Families
Hillary Clinton is one of the smartest people I know. The central goal of her presidency will be raising the incomes of working families, and she’s the only candidate with practical plans to achieve that goal. ... Hillary has also answered this question clearly when it comes to health care, trade and energy. She has called for repeal of the Affordable Care Act’s “Cadillac tax,” standing with working families who are seeing costs shifted onto their backs as their deductibles rise. (Howard Dean, 10/11)

Los Angeles Times: The Hijacking Of The House Of Representatives
[insurgent conservatives'] intransigence produced a series of fruitless crises. In 2011, they demanded that [Speaker John] Boehner refuse to allow a rise in the federal debt ceiling if Obama and the Democratic-led Senate didn't agree to all the spending cuts they wanted. The gambit failed. In 2013, they shut the federal government for 16 days in an attempt to force the repeal of Obama's health insurance program; that gambit failed too. After his decision to retire, Boehner denounced the GOP radicals as “false prophets” who misled their own voters. They “whip people into a frenzy believing they can accomplish things that they know — they know! — are never going to happen,” he said last week. But don't feel too bad for him: Boehner stood by while that whipping took place. (Doyle McManus, 10/11)

New Hampshire Union Leader: Medicaid Drives Up Costs: Hospitals Ignore ER Visits
Last week, the New Hampshire Hospital Association trumpeted a new report touting the benefits of expanded Medicaid. Since New Hampshire opened its Medicaid rolls, there are fewer uninsured patients seeking care at New Hampshire hospitals. ... But the NHHA’s full report contains other statistics not included in the news release. Emergency room visits are way up. Uninsured ER visits are down 5,600 from the same three-month period a year ago. But total ER visits are up by 5,000. So federal taxpayers are presumably paying for an additional 10,600 costly ER visits every quarter. (10/11)

Alaska Dispatch News: Alaska Legislative Leaders Should Abandon Medicaid Lawsuit, Deal With Policy
Somehow, it was no surprise that the Legislative Council emerged from a secret meeting in late September and refused to shut down its court fight against the Walker administration over whether the governor can approve Medicaid expansion this year. After all, the council members had decided during the summer it was smart strategy to pay the lawyers in advance. That might have something to do with it. ... Given the enormous financial challenges facing the state, this lawsuit ought to be abandoned, even with the $250,000 already committed to the D.C. lawyers. As a lawsuit over a narrow procedural question, the case does not address the future of Medicaid or the merits of providing health coverage to more Alaskans. That much is certain. (Dermot Cole, 10/11)

Wichita Eagle: Expanding Medicaid Is A Moral Question
The issue of the expansion of Medicaid coverage to 150,000 low-income Kansans is perhaps the issue that best illustrates the callous indifference of the Brownback administration to the plight of the disadvantaged. The administration, speaking through its deputy director of communications, believes that support for expansion of Medicaid coverage is “morally reprehensible” (Oct. 7 Eagle). The scope of the governor’s indictment is, to be charitable, breathtaking inasmuch as 64 percent of Kansans and 58 percent of Kansas Republicans support expansion of Medicaid, according to a recent poll. (E.L. Lee Kinch, 10/10)

Bloomberg: Paid Family Leave's Conservative Lineage
When the Republican presidential candidate Marco Rubio unveiled a proposal last month to subsidize family leave via a system of tax breaks for businesses, Democrats scoffed. Expanding protection of mothers and infants? Isn't that Democratic turf? Before Democrats get too indignant, they should remember that when it comes to family leave -- and maternity leave in particular -- conservatives, not liberals, have historically taken the lead. (Stephen Mihm, 10/9)

The Denver Post: Completed Aurora VA Hospital Is In Sight
Finally, a completed Aurora VA hospital is in sight. In early October, Congress voted to fully fund its construction, and the president has signed the legislation. This was no small feat. Despite the Department of Veterans Affairs' (VA) gross mismanagement and negligence, I look forward to celebrating the completion of the VA hospital in Aurora thanks to a bipartisan effort from the Colorado delegation. (Mike Coffman, 10/10)