KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Political Cartoon: 'Planning To Diet?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Planning To Diet?'" by Bob and Tom Thaves.

Here's today's health policy haiku:


Tale of two co-ops
One comes undone; one still works.
What does it all mean?

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

Number Of People Shopping For Health Plans On Spanish-Language Version Of Lags Behind Hopes

News outlets also report on a range of issues related to the health law's implementation, including an upcoming IRS reporting deadline for large and mid-size businesses, as well as how the cancellation of plans causes consumers to scramble and how the rise in premium costs is creating financial pressures for some.

The Washington Post: Little Headway In Attracting More Hispanics To ACA Health Coverage
The number of people shopping for medical insurance on the Spanish-language version of is lagging behind last year's interest, even as the Obama administration urges Hispanics to sign up for coverage under the Affordable Care Act. Federal figures released Wednesday show that about 153,000 people used during the first three weeks of the current enrollment season for ACA health plans, down from 244,000 during the same period a year ago. (Goldstein, 11/25)

The Richmond Times-Dispatch: Employers Face Affordable Care Act Reporting Deadline
Human resource advisers to large and midsize businesses are sounding the alarm at approaching deadlines for meeting IRS requirements under the Affordable Care Act. The requirements had been postponed for a year, but employers have to submit forms to full-time workers by the end of January and report to the IRS by the end of March. (Martz, 11/29)

The Chicago Tribune: Blue Cross Cancellation Sends Consumers Scrambling
Rick Jago talks about his doctor at Northwestern University in emotional terms. The 57-year-old Homer Glen resident credits Dr. Jyoti Patel with saving his life after he was diagnosed with lung cancer five years ago. He sees her every six months to make sure the cancer hasn't returned. "I love this woman," said Jago. "The only woman I love more than her is my wife." What he's not in love with is his health insurance. Blue Cross and Blue Shield of Illinois is canceling his PPO plan at the end of the year. The big insurer offered to transfer him to another health plan, but there's a problem. Patel is not in the network. (Sachdev, 11/27)

The Charlotte Observer: Rise In ACA Premiums Pushes Some Consumers To Seek Cheaper Health Insurance Options
Fall always is a busy season for Norma Jean Rector, a SouthPark insurance benefits adviser. But this year, the third for open enrollment under the Affordable Care Act, more customers than ever are begging for help to find affordable health insurance. “In the two years past, there was interest,” she said, “but not like this year.” North Carolina’s health insurance rates under the ACA are going up as much as 50 percent on some policies next year. While experts debate the reasons for the spike and critics continue to question the value of “Obamacare,” some consumers and insurers are taking dramatic steps to contain their costs. (Garloch and Murawski, 11/26)

Meanwhile, The New York Times reports on the latest efforts by Kentucky's governor-elect to unravel the state's health law implementation while other news outlets offer ACA-related developments -

The New York Times: Kentucky, Beacon For Health Law, Now A Lab For Its Retreat
Over the last few years, Kentucky captured the nation’s attention as the only Southern state to wholly embrace the health care law .... Now, with [Gov.-elect Matt] Bevin promising to “repeal the expansion as it currently exists,” Kentucky may become a laboratory for the kind of rollback that the law’s opponents have so far only dreamed of. Nationally, both parties saw the governor’s race as a crucial political test for the Affordable Care Act months after it survived a second major challenge before the Supreme Court. Republicans were elated by Mr. Bevin’s sound defeat of Jack Conway, the state’s Democratic attorney general, seeing it as a blatant rejection of the health law and proof that it remains a giant liability for Democrats heading into 2016. ... For Democrats, Mr. Conway’s loss illustrated the challenges they may face motivating voters in next year’s presidential and congressional races, not least those the health law is helping. (Goodnough, 11/27)

The Chicago Tribune: Health Care Options Grow As Physician Shortage Looms
The Association of American Medical Colleges projects that the nation will face a shortage of 12,000 to 31,000 primary-care physicians by 2025. So it’s no wonder you may be finding it harder to find a doctor or to schedule an appointment with the one you have. What’s fueling this problem? The baby boom generation pouring into older age, an aging physician workforce preparing to retire and an estimated 30 million Americans joining the ranks of the insured since enactment of the Affordable Care Act in 2010. What that means is that you may not be seeing a doctor at all the next time you go for health care. (Kraft, 11/28)

The San Antonio Express-News: Students Go Mobile To Educate Community About Health Insurance
Navigating health insurance can be confusing, especially for people obtaining coverage for the first time through the Affordable Care Act marketplace. Students at the University of Texas Health Science Center wanted to help, so they created a mobile phone app to help educate Bexar County residents about health coverage. The SA Access app is available in English and Spanish for iOS and Android and can be downloaded free at (Belasco, 11/26)

The Dallas Morning News: Texas Taking Part In Obamacare Program To Help Disabled Adults Live Outside Institutions
Texas consistently ranks at or near the bottom on funding services for people with intellectual and developmental disabilities. But there’s a new pool of money rolling out that could help change that. It comes from Obamacare. It’s an entitlement program. And Texas is one of five states taking part, thanks to legislation by one of the state’s most conservative senators. (Taketa, 11/28)

Collapse Of Co-Ops, Other Signs Of Market Instability Draw Concerns From Across The Spectrum

The demise of New York's Health Republic is the most recent health insurance co-operative to come undone, though some -- like a Connecticut co-op -- offer a different story.

The New York Times: Instability In Marketplaces Draws Concern On Both Sides Of Health Law
The latest turmoil in health insurance marketplaces created by the Affordable Care Act has emboldened advocates on both sides of the political spectrum, providing ammunition to conservatives who want to shrink the federal role and liberals who want to expand it. UnitedHealth Group rattled federal officials when it announced last week that it was losing money in the insurance exchanges .... Those concerns followed the collapse of 12 of the 23 nonprofit insurance cooperatives .... In addition, insurance markets in many states are unstable. Premiums are volatile. Insurers say their new customers have been sicker than expected. And the law is as divisive as ever. (Pear and Goodnough, 11/27)

The Wall Street Journal: New York Health Co-Op’s Collapse Hits Physicians
Mount Kisco Medical Group PC, in the Hudson Valley, provided care to more than 13,000 patients who used Health Republic Insurance of New York. But the insolvent insurer, which the state and federal regulators shut down in September, left the Mount Kisco medical practice with millions of dollars in unpaid claims, said Scott Hayworth, a physician and the group’s president and chief executive. (Ramey, 11/27)

USA Today: Health Republic Is Latest Health Care Co-Op To Go Under
About 200,000 New Yorkers will see their Health Republic policies expire on Monday, marking the demise of the 12th health insurance co-op established under the Affordable Care Act. That's more than half of the 23 consumer operated and oriented plans that were created with federal loan money to promote competition on the state online exchanges selling insurance under the 2010 health care law. The 12 co-ops, which received $1.2 billion in taxpayer-funded loans, failed for a variety of reasons (Tumulty, 11/29)

Kaiser Health News: A Tale Of Two Obamacare Co-Op Insurers: One Standing, One Falling
Thousands of Americans are again searching for health insurance after losing it for 2016. That’s because health cooperatives — large, low-cost insurers set up as part of Obamacare — are folding in a dozen states. The failure of Colorado’s co-op has hit Rick and Letha Heitman hard. They are currently customers of the Colorado HealthOP, which is closing up shop at the end of the year. The couple, who own a contracting business, say the co-op proved to be a life-saver when Rick was diagnosed with aggressive prostate cancer last spring. (Daley and Cohen, 11/30)

Capitol Hill Watch

GOP And Dems Still Divided Over Budget Issues As Deadline For Passage Approaches

Funding for the federal government expires on Dec. 11, and the parties are at odds about policy riders and funding decisions that could be part of the bill to keep the government running.

The Associated Press: Congress Returns To Looming Deadlines On Budget, Highways
Lawmakers are returning to Capitol Hill to wrap up work on the budget, highway funding and taxes, an end-of-the-year stretch that will test the standing of Republican leaders like House Speaker Paul Ryan with the GOP's tea party wing and its anti-establishment presidential candidates. There are less than two weeks until a deadline to pass a $1.1 trillion catchall spending bill to fund Cabinet agencies and avoid a holiday season government shutdown. If the process doesn't go smoothly, a last-minute temporary funding measure would be required to keep the government open when the current stopgap funding measure expires Dec. 11. (Taylor, 11/30)

USA Today: Congress Faces Raft Of Issues In Spending Deadline To Avoid Shutdown
For Congress, the next two weeks are all about figuring out how to keep the government open. But that debate is about far more than Planned Parenthood and Syrian refugees. The federal government is running on a stop-gap funding bill that expires Dec. 11 because Congress has not yet passed legislation to fund federal agencies for 2016. ... Beyond the riders, Congress is now weighing changes in funding for hundreds of programs across the federal government, many of which have not been reconsidered in years. Sen. Roy Blunt, R-Mo., who chairs the appropriations subcommittee that handles the departments of Labor and Health and Human Services, noted his panel boosted funding for National Institutes of Health to conduct research on Alzheimer's, anti-microbial resistance and other priorities, but it did so by cutting funding for the National Labor Relations Board and other programs more popular with Democrats. (Singer, 11/29)

The Associated Press: Race To Settle Budget Fight Means Resolving Policy Disputes
Republicans have laced the spending bills with add-ons that take on Obama's health law, new environmental regulations, and the 2010 Dodd-Frank law tightening oversight of the financial services industry. If history is any guide, Obama and Democrats — whose votes will be needed to pass the catch-all spending bill — will ward off most of them. But lots of lower-tier issues are in play. ... What to know about riders and how they make it into legislation, or don't. (Taylor, 11/28)

Congress Struggles To Find Consensus On Comprehensive Mental Health Bill

Some high-profile attacks by people with mental health problems have prompted interest in reforming treatment options, but Congress has not yet settled on a policy.

The Kansas City Star: Three Years After Sandy Hook, Mental Health Overhaul Remains Stubbornly Out Of Reach
Nearly three years after a deeply disturbed man killed 26 children and adults at an elementary school in Connecticut, Congress is still struggling to reform the nation’s system for diagnosing and treating mental illness. A major mental health overhaul bill offered in the weeks following the shootings still sits in a House committee, hamstrung by opposition from some mental health treatment experts, privacy advocates and legislators. Similar comprehensive mental health bills have languished since the Sandy Hook Elementary School massacre, frustrating the mental health community and some politicians. (Helling, 11/27)

Politico: Mental Health Bill Collides With Guns — Again
The spate of mass killings over the past year reignited mental health reform efforts in both chambers of Congress. A bipartisan bill is gaining momentum in the Senate, with the Committee on Health, Education, Labor and Pensions likely to take it up early next year. The House Energy and Commerce subcommittee on health recently approved a similar bill, and Speaker Paul Ryan this month said on “60 Minutes” that he wants Congress to move ahead on mental health. But the Senate’s No. 2 Republican, John Cornyn of Texas, has been working behind the scenes to drum up support for his own mental health legislation, which includes language endorsed by the National Rifle Association. (Ehley, 11/29)


Pfizer-Allergan Merger Could Disrupt Companies That Conduct Research For Drug Giants

In other prescription drug news, the head of Turing Pharmaceuticals says the company's decision to raise the parasitic infection treatment Daraprim to $750 a pill from $13.50 a pill "doesn't affect the system at all." In other pharma news, The New York Times reports on the Coalition for Affordable Drugs, a company set up to challenge weak or abusive patents.

Bloomberg: Pfizer May Cause Research Firms Short-Term Pain, Long-Term Gain
The marriage of two of the biggest U.S. drugmakers is not without consequences for the rest of health- care supply chain, particularly for the firms that handle their outsourced research and development work. Pfizer and Allergan agreed Monday to a $160 billion deal that gives Pfizer a suite of new therapeutic development areas like eye care, women's health and antibiotics. With the merging of any two pharmaceutical giants comes overlap and cuts, in part from research and development. (Koons, 11/27)

Bloomberg: Shkreli Says Price Increases For Turing Drug Don't Matter
Martin Shkreli, whose pharmaceutical company has been criticized for raising the price of a drug by more than 5,000 percent, said the increase barely causes a ripple in the health-care system. Shkreli’s company, Turing Pharmaceuticals AG, this year raised the price of Daraprim, used by HIV and cancer patients, to $750 a pill from $13.50 a pill. The company gives away or heavily discounts the treatment for many patients, Shkreli said in an interview on Bloomberg TV. (Armstrong and Mittelman, 11/25)

The New York Times: Working To Lower Drug Costs By Challenging Questionable Patents
J. Kyle Bass made a fortune in the financial crisis when his hedge fund, Hayman Capital Management, bet big against subprime mortgages. Now Mr. Bass is wagering against pharmaceutical companies that he says exploit the patent system, keeping drug prices — and their profits — in the stratosphere. He has a formidable colleague in the effort: Erich Spangenberg, a man who became reviled in Silicon Valley for bringing lawsuits against technology companies that he contended had infringed on a patent. By mid-November, the firm had filed 33 requests for patent reviews, targeting 13 drugs from a dozen companies. (Morgenson, 11/27)

Meanwhile, other pharmaceutical developments target diabetes, dermatological conditions and rheumatoid arthritis -

Marketplace: Diabetes Prevention Becomes Lucrative Growth Industry
The Centers for Disease Control and Prevention report 86 million American adults have prediabetes, and of those, as many as a third will become diabetics within five years. Beginning January 1, 2015, virtually all private insurers must cover services — with no copay — that help people with elevated blood sugar levels change their diets and increase their physical activity. (Gorenstein, 11/27)

Reuters: Dermatology Drug Prices In U.S. Soared In Recent Years
The price of many drugs prescribed by U.S. dermatologists has skyrocketed over the past six years, far exceeding increases in overall health care costs and stretching patients' budgets in an era of high insurance deductibles, according to a new study from Florida. Of the 19 drugs analyzed, price increases between 2009 and 2015 ranged from about 60 percent to 1,698 percent, with an average rise of more than 400 percent. (Seaman, 11/25)

Reuters: Amgen Files For U.S. Approval Of Biosimilar To Humira
Amgen Inc on Wednesday said it filed with U.S. health regulators seeking approval to sell its first biosimilar drug, which would be a less expensive alternative to AbbVie's Humira, the world's top-selling prescription medicine. Amgen said its drug, ABP 501, has demonstrated clinical equivalence and comparable safety to Humira (adalimumab) in late stage clinical trials for rheumatoid arthritis and the skin condition plaque psoriasis. Data to support the switching of patients from Humira to ABP 501 was included in the submission to regulators, Amgen said. (Berkrot, 11/25)


Detailing New Medicare Part B Premium Help

Changes signed into law by President Barack Obama will help shield some 17 million Americans from steep premium hikes. Elsewhere, longer wait times — and administrative appeals — make some with Social Security disability benefits wait.

The Associated Press: Long Wait Times Plague Social Security Disability Process
Overburdened administrative judges are working through huge caseloads of these appeals all over America, but Miami has the country's longest average wait for a hearing, at 22 months. And while they wait, many slip into poverty, burdening their families and dragging down the economy. Experts blame aging baby boomers for the backlog, which piled up after the Social Security Administration got $1 billion less in funding than it sought for more staff. (Kennedy, 11/28)

Public Health And Education

Abortion Debate's Polarized Rhetoric Scrutinized After Colorado Planned Parenthood Shooting

News outlets examine the contention from abortion rights groups that the recent escalation of the abortion debate may have contributed to this attack. Meanwhile, articles also look at how the shooting may add to the challenges on Capitol Hill and may lead clinics to re-examine their security measures.

The Washington Post: Abortion Rights Groups: Political Rhetoric Contributed To Shooting
To many abortion rights advocates, it seemed only a matter of time before something like this happened. Ever since the summer, when an antiabortion group accused Planned Parenthood of illegally selling fetal tissue, threats against the organization had escalated to unprecedented levels, abortion providers say. They stepped up collaboration with the FBI and local police and stiffened security at clinics. But on Friday, their worst fears came true: A man walked into a health center in Colorado Springs and opened fire. (Somashekhar, 11/29)

The Wall Street Journal: Planned Parenthood Shooting Escalates Abortion Debate
The shooting Friday at a Colorado Springs, Colo., Planned Parenthood clinic that left three dead reverberated among activists, lawmakers and presidential candidates already entrenched in clashes over abortion. The suspect in the attack, Robert Lewis Dear, told authorities “no more baby parts” after being apprehended, said a law-enforcement official. Antiabortion activists this year released undercover videos in which Planned Parenthood officials spoke about the group’s provision of fetal tissue from abortions for use in medical research. Abortion opponents use the phrase “baby body parts” in discussing the videos and accused Planned Parenthood affiliates of “selling” them. Planned Parenthood officials denied wrongdoing but said they would stop taking reimbursement for the cost of supplying the tissue. (Radnofsky, Karmin and Frosch, 11/29)

The New York Times: Shooting At Planned Parenthood Adds To Challenges For Congress
Even as the authorities say they remain uncertain what precisely led a gunman to attack a Planned Parenthood facility in Colorado Springs on Friday, a comment attributed to the suspect by a senior law enforcement official — “no more baby parts” — fed directly into an already high-pitched controversy over Planned Parenthood and its practices. (Calmes, 11/29)

The Associated Press: 'No More Baby Parts': Reclusive Suspect's Words Draw Focus
Robert Lewis Dear told authorities “no more baby parts” after being arrested in the shooting at a Colorado Planned Parenthood clinic, according to a law enforcement official, part of a rambling statement that investigators are parsing to understand the reasoning behind an assault that left three dead. Colorado Springs police said Sunday they would not disclose any information on the motive for the attack, a move that guarantees further speculation over Dear’s intentions. (Gurman, 11/29)

Reuters: Planned Parenthood To Reassess Security After Colorado Attack
Planned Parenthood was already on heightened alert against threats of violence this year after a storm of criticism from abortion opponents over how it handles the tissue of aborted fetuses used for medical research. Now some affiliates of the reproductive health organization say they will scrutinize their security measures even further after a gunman's deadly attack on one of the nonprofit's clinics in Colorado on Friday. (Jenkins, 11/29)

The Associated Press: Planned Parenthood Under Fire Literally And Figuratively
The fatal shootings at a Colorado Planned Parenthood clinic are the latest in a long history of violence at clinics that provide abortions and doctors who perform the procedure. Police aren't saying what motivated this most recent shooting. The attack comes as the nonprofit endures criticism from anti-abortion lawmakers and renewed protests outside clinics since a group of abortion opponents released videos they claimed showed the organization negotiating fetal tissue sales. (Melley and Crary, 11/29)

The Washington Post: It’s Not Known Why A Gunman Stormed A Planned Parenthood, But Abortion Providers Often Face Attacks
If the shooting Friday is determined to have been specifically an attack on Planned Parenthood, it would have been in a long line of attacks on abortion providers over the years. It has been six years since anyone was killed in connection with the abortion debate, but attacks on clinics and doctors are fairly regular, according to a list maintained by the National Abortion Federation, a pro-abortion rights organization. Over the past 20 years, there have been an average of 257 incidents a year directed at abortion clinics and staff, and an average of 139 over the last five years. The bulk of those incidents are vandalism and trespassing, although the total also includes shootings, bombings and assaults. (Ehrenfreund, 11/28)

The New York Times: Siege Highlights Security Used In Abortion Clinics
As the heavily armed police entered the Planned Parenthood clinic here to hunt down the gunman and rescue those trapped inside, they had an advantage that seemed like something out of the movies. Officers in the command center outside the clinic were able to tap into security cameras throughout the complex, watch the siege unfold and give precise instructions to officers inside. ... The advanced camera system was just one sign of the increasingly elaborate security measures that abortion clinics around the country have adopted. (Healy and Eckholm, 11/28)

The New York Times: Obama Says ‘Enough Is Enough’ After Colorado Shooting
President Obama responded angrily on Saturday to the mass shooting that took three lives, including that of a police officer, at a Planned Parenthood facility in Colorado Springs over the Thanksgiving holiday, calling the country’s recurring outbreaks of gun violence “not normal.” “We can’t let it become normal,” Mr. Obama said in a statement. “If we truly care about this — if we’re going to offer up our thoughts and prayers again, for God knows how many times, with a truly clean conscience — then we have to do something about the easy accessibility of weapons of war on our streets to people who have no business wielding them. Period. Enough is enough.” (Martin, 11/28)

Campaign 2016

Presidential Candidates' Health Care Positions Would Affect Consumers' Finances, Retirement Plans

Meanwhile, The Associated Press details presidential hopeful Bernie Sanders' plans to "repeal and replace" Obamacare, while The New York Times checks in on Sen. Ted Cruz's campaign. News outlets also report on how the GOP field is dealing with the Planned Parenthood shooting in Colorado Springs and the drug abuse issue.

CBS News: Where Candidates Stand On Medicare And Health Reform
A critical part of your retirement planning is to make sure you have sufficient medical insurance. Your options will be significantly influenced by our political leaders' positions on how the government should pay for Medicare and health care for retirees over the next few years and decades. (Vernon, 11/30)

The Associated Press: What To Know About 'BernieCare,' Sanders Health Overhaul
The most ambitious "repeal and replace" health care plan from a presidential candidate comes from Sen. Bernie Sanders, not from a Republican. The Vermont independent who's seeking the Democratic nomination has been chastised by front-runner Hillary Rodham Clinton for espousing an all-inclusive, government-run system. It's called the "single-payer" plan, loosely modeled on how health care is financed in Canada and most of Western Europe. (Alonso-Zaldivar, 11/27)

The New York Times: Ted Cruz Surges In Iowa, Powered By Outsider Fervor
Among Mr. Cruz’s admirers at the general store was Terri Bennett, 43, of Knoxville, Iowa, who said she caucused for Hillary Rodham Clinton in 2008. “We watched him filibuster Obamacare, and I said, ‘I wish he’d run for president,’ ” Ms. Bennett said. Outside, a local pastor, Joshua Verwers, waited to pray with Mr. Cruz, whom he called “one of the few running who are still biblically qualified to hold office,” along with Mike Huckabee and Rick Santorum. (Flegenhaimer, 11/29)

The Washington Post: GOP Contenders Nearly Silent On Colorado Springs Shooting
The Republican presidential field, which for much of the year has been full-throated in its denunciations of Planned Parenthood, has been nearly silent about the shooting in Colorado at one of its facilities that left a police officer and two others dead. In contrast, all three of the leading Democratic contenders quickly issued statements in support of Planned Parenthood. (Tumulty, 11/29)

The Washington Post: GOP Contenders Are Talking About Drug Abuse, But Racial And Partisan Rifts Persist
[M]any GOP presidential candidates are calling for an end to one of its central tenets — by agreeing with Democrats to treat low-level drug offenders rather than incarcerating them. The Republicans are selective, however, about who is deserving of their compassion. Several GOP presidential contenders have advocated treating the nation’s growing heroin epidemic as a health crisis, not a criminal one. But most stop short of advocating the same approach to other drug laws, notably those involving marijuana and crack cocaine, which disproportionately affect African Americans. (Phillip and Zezima, 11/27)

State Watch

Planned Parenthood Considers Suit Against Missouri If Clinic's Abortion License Is Revoked

Only one clinic in the state still performs abortions after another halted the procedures last week. In other state news, Washington's attorney general’s office finds no wrongdoing by Planned Parenthood in the state following a review prompted by a July letter from Republican state lawmakers.

The Associated Press: Missouri Planned Parenthood Says Legal Action Likely
A regional Planned Parenthood official said Wednesday that the organization likely would take legal action against the state of Missouri after a Columbia clinic halted abortions this week, leaving just one in the state that still performs them. Laura McQuade, president and CEO of Planned Parenthood of Kansas and Mid-Missouri, said the organization would sue the state Department of Health and Senior Services if it revokes the clinic's abortion license. That action is expected after panel of University of Missouri Health Care medical staff voted in September to discontinue the form of privileges granted to Planned Parenthood doctor Colleen McNicholas, effective next week. (Ballentine, 11/25)

The Seattle Times: State AG's Office Clears Washington Planned Parenthood Of Wrongdoing
After allegations that Planned Parenthood has illegally profited from the sale of fetal tissue, the state Attorney General’s Office has found no wrongdoing by Planned Parenthood in Washington state. The review was prompted by a July letter from Republican state lawmakers urging Attorney General Bob Ferguson to investigate Planned Parenthood clinics in the state. The letter came after controversial undercover video of a national Planned Parenthood medical director eating lunch while discussing procedures and prices for delivering tissues from aborted fetuses to researchers. (O'Sullivan, 11/28)

State Highlights: Gov. Cuomo Touts N.Y.'s Progress In Fight Against AIDS; Judge Advises Iowa To Throw Out One Of Four State Medicaid Management Contracts

News outlets report on health care developments in New York, Iowa, Florida, Missouri, Ohio, Washington, Michigan, California, Mississippi, Illinois and New Jersey.

The New York Times: Cuomo To Highlight New York’s Progress In AIDS Fight
Prescriptions for Truvada, a drug that protects against H.I.V. infection, have more than tripled since summer 2014 among people enrolled in Medicaid in New York State. Separately, the transmission of H.I.V. infections from mother to child dropped to zero in the state for the first time since the AIDS epidemic began. Gov. Andrew M. Cuomo, a Democrat, will highlight both statistics in a speech at the Apollo Theater in Harlem on Tuesday as part of World AIDS Day, portrayed as signs of progress toward the ambitious goal he announced last year to effectively end the AIDS epidemic by 2020 in the state that was once its epicenter. (Bernstein, 11/29)

Des Moines Register: Judge Recommends Throwing Out 1 Of 4 Medicaid Contracts
An administrative law judge has recommended that Iowa throw out one of the four contracts awarded to for-profit companies that are in line to manage Iowa’s Medicaid program. The ruling calls for the state to reverse the contract awarded to WellCare, a company that has faced millions of dollars in fines for fraud or mismanagement in other states and last year saw three former executives sentenced to prison for fraud convictions. (Clayworth, 11/26)

Health News Florida: Feds Propose Fix For Surprise Medical Bills
Florida legislators have been grappling with the problem of balance billing—also known as “surprise billing”—and now the Center for Medicare and Medicaid Services has proposed a broader rule aimed at fixing the issue. Balance billing is what happens when a patient goes in for a procedure and gets surprised with a bill because one of the providers or treatments in the process isn’t covered by the insurance company. For example: If someone goes to an in-network hospital for an operation and sees an in-network surgeon, there still might be an out-of-network specialist who has to be consulted while the patient is under anesthesia. Depending on the insurer, that patient can be on the hook for a surprisingly large bill for the out-of-network treatment. (Mack, 11/29)

The Associated Press: Assaults On Staff At Western State Hospital Costing Millions
A psychiatric patient “head-butted” a nurse so hard she fell back and her head was slammed against a door, causing injures that kept her home for three months. An agitated patient knocked a nurse onto a concrete floor, causing injuries that forced him out of work for seven months. A nurse who tried to stop a patient attack was in hurt so seriously that her recovery took more than two years. Hundreds of employees at Washington state’s largest psychiatric hospital have suffered concussions, fractures, bruises and cuts during assaults by patients, resulting in millions of dollars in medical costs and thousands of missed days of work. (Bellisle, 11/27)

The Battle Creek Enquirer: Ex-Mental Health CEO Pleads Guilty, Will Pay $1M
The former CEO of a Battle Creek mental health care agency will pay more than $1 million after pleading guilty to felony charges Wednesday and could face up to 17 months behind bars. Under a plea agreement, Erv Brinker will pay $510,000 in restitution and an additional $510,000 in civil penalties, totaling $1,020,000. For nearly 25 years, Brinker led Summit Pointe before he was fired for cause in mid-February. It brought to an end the independent mental health agency’s months-long internal investigation in which issues were raised about conflicts of interest with longstanding vendors and the pension plan. (Bowman, 11/25)

Los Angeles Times: L.A. County Supervisors Choose Mitch Katz To Head Health Agency
Los Angeles County supervisors have officially announced that Dr. Mitch Katz, who heads the county hospital system, will run a new health super-agency that contains the hospital system and the departments of mental health and public health. Katz's selection was seen in county circles as a foregone conclusion, but the supervisors formalized the decision in a closed-door meeting Tuesday. (Sewell, 11/25)

The Associated Press: In Medical Marijuana States, 'Pot Doctors' Push Boundaries
The green-typeface slogan "WE'ED like to be your doctor!" —unmistakably weed-friendly — has attracted hundreds of medical marijuana patients in less than a year to Dr. Bodo Schneider's clinics in southern Illinois and suburban Chicago. In New Jersey, Dr. Anthony Anzalone has a similar following at his three clinics, marketed online with a marijuana leaf logo and a "DrMarijuanaNJ" web address. The two marijuana-friendly doctors in states with similar laws face starkly different treatment by government regulators. When it comes to oversight of boundary-pushing doctors, enforcement practices vary in the 23 states allowing medical cannabis. (Johnson, 11/27)

The Daily Journal: Make Way For Babies: Advocates Seek To Build On Mississippi's Success
Mississippi’s record drop in infant mortality means 64 more toddlers are disrupting Thanksgiving celebrations today. The state saw 64 fewer infant deaths from 2013 to 2014. When combined with an increase in the number of births in 2014, the infant morality rate dropped from 9.7 per 1,000 births in 2013 to 8.2 in 2014. That’s a 15-percent drop between 2013 and 2014, and a 28 percent drop since 2005. (Morris, 11/25)

The Associated Press: U. Of C. Part Of Push For Person-Centered Health Care
Every time JoAnna James took her husband, Lawrence, to the doctor, she left the hospital without understanding what was wrong with him. “You ask them to break it down so you can understand what they are saying,” the 67-year-old woman says of doctors, “and they make you feel like there is something wrong with you.” (11/27)

Politico: War Over Soda Taxes Coming To A Polling Place Near You
Government do-gooders and conservatives who are worried that America is becoming a nanny state have one more thing to fight about in 2016: soda taxes. Public health advocates, flush from victories in Mexico and Berkeley, California, are plotting to bring voter referendums and legislation to tax soda in as many as a dozen U.S. cities in 2016. It’s all part of an international strategy backed by billionaires in New York and Texas, including former New York City Mayor Michael Bloomberg, to reduce consumption of sodas, juices and other sugary drinks in the fight against spiraling rates of obesity, diabetes and other diet-related diseases. (Bottemiller Evich, 11/29)

The Associated Press: VA Foster Care Program Offers A New Kind Of Home For Senior Veterans
Morning coffee at the kitchen table. Roque (Rocky) Riojas, 93, sits at one end, Bronze Star cap on his head, World War II shrapnel in his leg, and he’s telling how his son always comes to visit. At the other end of the table, Theodosia Mobley, 84, who fought in Korea, scoffs: “He doesn’t always come to visit.” They are part of a new Veterans Affairs program that places military veterans in homes of people willing to open a door. Pretty much like the foster kid system. Most of these vets are old and alone. They have health problems and nowhere else to go other than a nursing facility, and they don’t want to go there. (Bradley, 11/27)

Editorials And Opinions

Viewpoints: Generational Disparities On Entitlements; Fears On Iowa's Medicaid Plan

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

The Washington Post: Generational Warfare, Anyone?
An enduring puzzle of our politics is why there isn’t more generational conflict. By all rights, younger Americans should be resentful. Not only have they been tossed into the worst economy since the 1930s, but also there’s an informal consensus that the government, whatever else it does, should protect every cent of Social Security and Medicare benefits for the elderly. These priorities seem lopsided and unfair. Generational distress isn’t an abstraction; it’s repeatedly reaffirmed. (Robert J. Samuelson, 11/29)

Des Moines Register: Concerns Over Medicaid Plan Are Justified
Perhaps the most maddening aspect of Gov. Terry Branstad’s ill-conceived and poorly executed rush to privatize the Medicaid program is the manner in which he and the private contractors he has hired to take over the program dismiss the concerns of others. We understand that some people fear change, they tut. We understand some people are afraid of things that are new and different, they cluck. These reproachful, condescending responses to legitimate, justifiable concerns over the health and welfare of more than half a million low-income and disabled Medicaid beneficiaries demonstrate just how little regard the Branstad administration has for the people of Iowa, only 22 percent of whom support his privatization plan, according to an Iowa Poll in April. (11/28)

The Washington Post: Cleaning Up Bobby Jindal’s Mess In Louisiana
Mr. Jindal also bears responsibility for his decision to “fight Obamacare” by refusing to accept federal funds to expand Louisiana’s Medicaid program. Under the Affordable Care Act (ACA), the federal government has offered to foot practically the entire bill for increasing access to the health-coverage program to very-low-income workers. Analysis after analysis in state after state has shown that there are no good reasons, beyond anti-Obamacare demagoguery, for states to reject the Medicaid expansion. In Louisiana, 192,000 people would receive access to health-care coverage. Without the expansion, these people end up with less help than do those who earn far more. (11/26)

The Wall Street Journal: Winning The Right To Save Your Own Life
In just over a year, 24 states have passed right-to-try laws, including Texas, Florida and Virginia. ... California nearly became the 25th state with such a law. But on Oct. 11, less than a week after signing a right-to-die bill into law that allows terminally-ill patients to be prescribed drugs to end their lives, Gov. Jerry Brown vetoed the right-to-try bill. Gov. Brown’s reasoning? A perfect Catch 22: “Patients with life threatening conditions should be able to try experimental drugs, and the United States Food and Drug Administration’s compassionate use program allows this to happen.” No, it does not. (Darcy Olsen, 11/26)

The New York Times: A Step Forward For Contraceptive Access
Patients seeking birth control pills today typically have to get a prescription from a doctor, but reproductive health advocates have long argued that this process is unnecessary since the pills are safe for a vast majority of women. Now two states are about to allow patients to get them from a pharmacist without seeing a doctor first. Other states should consider similar moves. (11/28)

The Washington Post: The Problem With Obamacare’s Mental-Health ‘Parity’ Measure
Obamacare expanded health insurance to millions of Americans. But what good is insurance if there are no doctors available to treat them? This month, I found out, first hand. I saw a woman falling through the cracks of the new health-care system, and I tried to help her. ... Obamacare provides mental-health “parity,” meaning mental health is covered as well as any other condition — in theory, an important advance. But in practice, parity was meaningless for Isabella. She is enrolled in one of the CareFirst BlueCross plans from the Obamacare exchange, but when my friend and I searched for psychiatrists within 30 miles of Washington who took her plan, the CareFirst Web site returned none. (Dana Milbank, 11/27)

The Post-Tribune/Chicago Tribune: Open Enrollment Period Ensures Sobering Predictions
Over the course of several days, I thoroughly read the list of questions, familiar terms and common abbreviations. Then I read them all again. I'm still not sure if it helped. I'm talking about the open enrollment period for my health and life insurance benefits for 2016. Several key decisions had to be made, each one with serious financial ramifications if I chose poorly or wrongly. High deductible versus low monthly premiums. Co-pay versus co-insurance. In-network versus out-of-network. Health versus sickness. Life versus death, literally. (Jerry Davich, 11/27)

Reuters: A Pillar Of Medical Treatment Is Under Threat
When you’re sick, you expect the medicine a doctor gives you to work. But the effectiveness of one of the most important types of drugs — antibiotics — is under threat. In the United States alone, there are 2 million antibiotic resistant infections causing 23,000 deaths each year. You say that you never get sick, so this isn’t your problem. But what if I told you that antibiotics make modern medicine possible, including surgery, cancer treatment and organ transplants? Half of men and a third of women will get cancer in their lifetimes. Many treatments for cancer weaken the immune system, putting you at risk for infection. (Celine Gounder, 11/28)

The Washington Post: Let’s Talk About Dying
I am not banking on hospice or its cousin, palliative care, to prevent suffering at the end of my life or the lives of my loved ones. Instead, I want to rely on death-with-dignity laws that allow people with terminal illnesses to receive legal prescriptions for lethal medications. Because I am an American, I guess, I want to control what I can about my own life, including how it ends. (Janice Lynch Schuster, 11/27)

The New York Times: Contaminating Our Bodies With Everyday Products
In recent weeks, two major medical organizations have issued independent warnings about toxic chemicals in products all around us. Unregulated substances, they say, are sometimes linked to breast and prostate cancer, genital deformities, obesity, diabetes and infertility. “Widespread exposure to toxic environmental chemicals threatens healthy human reproduction,” the International Federation of Gynecology and Obstetrics warned in a landmark statement last month. The warnings are a reminder that the chemical industry has inherited the mantle of Big Tobacco, minimizing science and resisting regulation in ways that cause devastating harm to unsuspecting citizens. (Nicholas Kristof, 11/28)

The Wall Street Journal: The Food Cops And Their Ever-Changing Menu Of Taboos
With the release of the eighth edition of the U.S. government’s Dietary Guidelines expected by year’s end, it seems reasonable to consider—with the “obesity plague” upon us and Americans arguably less healthy than ever before—whether the guidelines are to be trusted and even whether they have done more harm than good. Many Americans have lost trust in the science behind the guidelines since they seem to change dramatically every five years. (David A. McCarron, 11/27)

The New York Times: The Heart Disease Conundrum
South Asians today account for more than half of the world’s cardiac patients. Heart disease is the leading cause of death in India, Pakistan and Bangladesh, and rates have risen over the past several decades. South Asian immigrants to the United States, like me, develop earlier and more malignant heart disease and have higher death rates than any other major ethnic group in this country. The reasons for this have not been determined. Traditional cardiac risk models, developed by studying mostly white Americans, don’t fully apply to ethnic communities. This is a knowledge gap that must be filled in the coming years. (Sandeep Jauhar, 11/28)