KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: August 16, 2017

Today's early morning highlights from the major news organizations.

Kaiser Health News: CBO: Killing Cost-Sharing Subsidies Would Hike Silver Plan Premiums And Deficit
The change would not be expected to have much long-term effect on the number of uninsured people, according to the analysis. But it could cause a shift in which plans are popular with marketplace customers as insurers realign some of their prices to defray the loss of the federal payments, the CBO said. Surprisingly, some customers might find better deals by looking at higher-end products. (8/15)

Kaiser Health News: Doctors Warm To Single-Payer Health Care
Single-payer health care is still a controversial idea in the U.S., but a majority of physicians are moving to support it, a new survey finds. Fifty-six percent of doctors registered either strong support or were somewhat supportive of a single-payer health system, according to the survey by Merritt Hawkins, a physician recruitment firm. In its 2008 survey, opinions ran the opposite way — 58 percent opposed single-payer. What’s changed? (Bluth, 8/16)

The Associated Press: Report: Higher Premiums If Trump Halts 'Obamacare' Subsidies
Premiums for a popular type of individual health care plan would rise sharply, and more people would be left with no insurance options if President Donald Trump makes good on his threat to stop “Obamacare” payments to insurers, the Congressional Budget Office says. The nonpartisan number crunchers also estimated that cutting off payments that now reduce copays and deductibles for people of modest incomes would add $194 billion to federal deficits over a decade. That head-scratching outcome is because a different Affordable Care Act subsidy would automatically increase as premiums jump, more than wiping out any savings. (Alonso-Zaldivar, 8/15)

The New York Times: Trump Threat To Obamacare Would Send Premiums And Deficits Higher
Even before efforts to repeal the Affordable Care Act collapsed in the Senate last month, Mr. Trump began threatening to stop paying the subsidies, known as cost-sharing reductions. He said the health care law would “implode” and Democrats would have no choice but to negotiate a replacement plan. Mr. Trump described his strategy as, “Let Obamacare implode, then deal.” Those threats continue, though the Trump administration has paid the subsidies each month. (Pear and Kaplan, 8/15)

The Wall Street Journal: What Are Insurance Subsidies And What Would Happen If They Were Cut?
As health insurers weigh their commitments to the Affordable Care Act’s exchanges for 2018, they point to a key issue that will affect the rates they would charge and indeed whether they will participate: Federal subsidies known as cost-sharing reductions. Those payments are likely to be a major story going forward, and on Tuesday, the Congressional Budget Office estimated that if President Donald Trump carried out his threat to halt the subsidies, it would boost premiums for middle-priced plans by 20% next year. (Wilde Mathews, 8/15)

The Wall Street Journal: Trump Targets McCain Over Health Vote
President Donald Trump continued his attacks against individual Senate Republicans, criticizing Sen. John McCain (R., Ariz.) and his pivotal health-care vote at a news conference Tuesday at Trump Tower in New York City. A week after Mr. Trump knocked Senate Majority Leader Mitch McConnell (R., Ky.) over the Senate’s failure to pass any legislation dismantling and replacing the Affordable Care Act, the president took aim at Mr. McCain, now in his sixth Senate term. (Peterson, 8/15)

The Hill: GOP Senator Meeting With White House On New ObamaCare Plan 
Sen. Bill Cassidy (R-La.) said he's meeting with the White House and the Trump administration "two or three times per week" on a plan to repeal and replace ObamaCare. Cassidy has teamed up with Sens. Lindsey Graham (R-S.C.) and Dean Heller (R-Nev.) on a new proposal that would essentially block-grant ObamaCare funding to the states while repealing the law's individual and employer mandates. (Hellmann, 8/15)

The Hill: White House To Pressure McConnell On ObamaCare
White House officials are exploring ways to pressure Senate Majority Leader Mitch McConnell (R-Ky.) to return to the controversial issue of ObamaCare repeal when the Senate returns to work in September. President Trump, who has repeatedly criticized McConnell in public, wants to hold the leader’s feet to the fire on the issue, say White House sources. (Bolton, 8/16)

The Wall Street Journal: Nevada And Centene Reach Agreement On Insurance Markets
Roughly 8,000 consumers in Nevada were at risk of losing access to health plans on the exchange after Anthem Inc. and Prominence Health Plan said in June they would exit markets in 14 counties. Insurers can hold off on final decisions to participate in exchanges until late September, but many have exited markets, citing volatility and prolonged uncertainty about the White House’s support for the markets. (Evans, 8/15)

The New York Times: Obamacare’s Bare County Problem Looks Mostly Solved, For Now
A few months ago, it looked as if large swaths of the country might end up without any insurers willing to sell Obamacare insurance in 2018. But in the last few weeks the “bare county” problem, which President Trump had cited as a sign the markets were failing, has nearly solved itself. On Tuesday, Gov. Brian Sandoval of Nevada announced that Centene would offer insurance in 14 rural counties of Nevada that had been bare. That leaves only two counties in the country without insurers saying they will sell coverage; fewer than 400 Obamacare customers live in those counties. (Sanger-Katz, 8/15)

Stat: CMS Moves To Cancel Medicare Programs Overhauling Some Hospital Payments
The Centers for Medicare and Medicaid Services moved to cancel pilot programs that would have paid certain hospitals a lump sum for all of the care associated with heart attacks, bypass surgeries, and some hip and femur fractures, including the initial visit, the surgery, and follow-up care. It’s canceling a similar program that targeted cardiac rehabilitation, and the agency is also proposing to drastically reduce the number of hospitals that have to participate in a separate program already underway that offers similar lump payments for hip and knee replacements. (Mershon, 8/15)

USA Today: FDA Chief Says Drug Makers Are Gaming The System To Slow Generic Competition; Vows Action
A day after President Trump lashed out at the black CEO of drug maker Merck on Twitter, his new Food and Drug Administration commissioner said brand name drug companies are "gaming the system" to block generic competition and vowed to do something about it. Physician and FDA chief Scott Gottlieb declined to comment on Trump's tweet urging Merck's Kenneth Frazier to lower drug prices after Trump's response to the violent Charlottesville, Va., protests prompted Frazier to resign from the White House manufacturing council. However, in a meeting Tuesday with USA TODAY's Editorial Board, Gottlieb didn't mince words when it came to his plans to stop what he said are anti-competitive actions by brand-name pharmaceutical companies that keep prices high. (O'Donnell, 8/15)

Politico: Trump Tweets Up A Storm On Drug Prices But Delivers Little Change
Back in January, Trump had signaled his intention to go after powerful drugmakers at his very first news conference, accusing the industry of “getting away with murder.” The issue is top of mind for voters — a bigger health priority than repealing Obamacare. But the White House has invested little political capital in the issue, appointing industry insiders to key posts while abandoning key campaign pledges to allow Medicare to negotiate drug prices and import cheaper medicines from overseas. (Karlin-Smith, 8/15)

Stat: Congressional Democrats May Form Expert Panel On Trump's Mental Health
Three congressional Democrats have asked a psychiatrist at Yale School of Medicine to consult with them about forming an expert panel to offer the legislators advice on assessing President Trump’s mental health. Yale’s Dr. Bandy Lee told STAT that over the last few weeks members of Congress or their staff have asked her to discuss how members might convene psychiatrists, psychologists, and other mental health professionals “to review the president’s mental health, and review it on a periodic basis.” The closed meeting is expected to take place in September, she said. (Begley, 8/16)

Politico: Colorado's Gardner Faces Blowback At Home Over Obamacare Repeal
Sen. Cory Gardner was hammered for supporting Obamacare repeal during a series of raucous town halls on Tuesday, where constituents repeatedly criticized his role in a closed-door partisan process to draft the failed GOP health bill. Gardner, who’s responsible for protecting the GOP majority in the Senate in 2018, faced heated criticism over the repeal effort that collapsed just a few weeks ago, even as congressional leaders try to pivot to tax reform when they return from the lengthy recess next month. (Pradhan, 8/15)

The New York Times: A Start-Up Suggests A Fix To The Health Care Morass
If you watched the drama in Washington last month, you may have come away with the impression that the American health care system is a hopeless mess. ... So it is surprising that across the continent from Washington, investors and technology entrepreneurs in Silicon Valley see the American health care system as the next great market for reform. (Manjoo, 8/16)

The Washington Post: Oregon Approves Sweeping Bill Expanding Abortion Access
Called the Reproductive Health Equity Act, the measure requires health insurers to provide birth control and abortion without charging a co-pay. It also dedicates state funds to provide reproductive health care to noncitizens excluded from Medicaid. Antiabortion groups swiftly condemned the new law, saying it will force taxpayers to foot the bill for a procedure many consider to be a form of murder, and that it cements Oregon’s status as the most liberal state when it comes to abortion. (Somashekhar, 8/15)

Reuters: Texas Governor Signs Bill To Limit Insurance Coverage For Abortions
The Republican governor of Texas signed into law on Tuesday a measure that will restrict insurance coverage for abortions, compelling women to buy a supplemental plan if they want coverage for the procedure. Governor Greg Abbott said the measure known as House Bill 214 would protect abortion opponents from subsidizing the procedure. Democratic critics decried it as forcing people to buy "rape insurance." (Herskovitz, 8/15)

The New York Times: A Changed Landscape For Abortion Rights In Texas
The drive between Del Rio and San Antonio consists of vast expanses of Texas farmland dotted with tiny towns. Along the route, a huge wooden sign in Hondo greets passers-by: “Welcome: This is God’s Country. Please don’t drive through it like hell.” By the time Kristen passed the sign on her way to get an abortion, she had been riding a Greyhound bus for four hours. The 150-mile trip was the shortest distance she could travel to visit an open clinic — Whole Woman’s Health in San Antonio. Her journey is not unique in Texas. (Van Houten, 8/16)

The Associated Press: Lawsuit Accuses Drug Manufacturer Of Worsening Opioid Crisis
South Carolina on Monday became the latest state to accuse a drug manufacturer of exacerbating its opioid drug crisis by using deceptive marketing. Attorney General Alan Wilson sued Purdue Pharma on Monday, accusing the maker of OxyContin and other opioid drugs of violating South Carolina's Unfair Trade Practices Act. (Kinnard, 8/15)

The Wall Street Journal: South Carolina Sues Purdue Pharma, Alleging Deceptive Opioid Marketing
South Carolina’s suit follows efforts by several other jurisdictions to hold pharmaceutical companies accountable for what they call deceptive marketing of opioid painkillers. The states and others say that such marketing has led to an epidemic among residents, leading to addiction, overdose and deaths. The lawsuit, filed in South Carolina state court, focuses solely on Purdue Pharma, which manufactures OxyContin and other opioid drugs. New Hampshire last week filed a similar suit against Purdue. (Randazzo, 8/15)

The Associated Press: US Teen Drug Overdose Deaths Inch Up After Years Of Decline
After years of decline, teen deaths from drug overdoses have inched up, a new U.S. government report shows. The drop in teen deaths had been a rare bright spot in the opioid epidemic that has seen adult overdose deaths surge year after year — fueled by abuse of prescription painkillers, heroin and newer drugs like fentanyl. (Stobbe, 8/15)

NPR: 'Body Brokers' Get Kickbacks To Lure People With Addictions To Bad Rehab
Some sober homes are good places. But others see a person who has an addiction as a payday. Amid the nation's growing opioid crisis, South Florida has become a mecca for drug treatment. And as more people arrive looking for help, there's more opportunity for corruption and insurance fraud. There are millions to be made in billing patients for unnecessary treatment and tests, according to officials investigating the problem. (Haden, 8/15)

The Associated Press: Colorful Portraits Show Faces Of New Hampshire Drug Crisis
At the New Hampshire State Library’s latest art exhibit, the bright smiles and bold colors of the canvases belied the broken hearts of those who attended its opening reception. More than 80 paintings are on display this month featuring the faces of the state’s opioid epidemic. What started as one mother’s private outlet for grief has grown into a larger effort to comfort others and reduce the stigma of addiction. (Ramer, 8/16)

The Wall Street Journal: How To Handle A Large, Unexpected Medical Bill
These days, not only are health-care costs climbing but individuals also often are bearing a greater portion of their medical bills than before, as many insurers cut back on payments and more companies expect employees to pay higher deductibles and copays.Meanwhile, many people don’t have sufficient emergency funds to pay for an unanticipated medical expense. ... Against this backdrop, advisers such as Mr. Van Zutphen (who successfully negotiated a 25% reduction on his long-ago bill) are encouraging clients to negotiate medical costs, question charges and move quickly to resolve disputes or arrange payment plans. (Dagher, 8/15)

The Washington Post: There’s Plague In Arizona. Authorities Warn Of Fleas That Can Infect People And Pets.
Public health officials in two Arizona counties are warning residents about the discovery of plague bacteria, an endemic concern among those who live in the American Southwest but unsettling, nonetheless, given the disease's devastating impact on human history. Navajo and Coconino counties are adjacent to one another, and in each community the findings are identical: Fleas carrying Yersinia pestis, the bacterium that causes plague, were discovered this month and pose a potentially grave threat to people and their pets, especially cats. (deGrandpre, 8/15)

News21: 63 Million Americans Exposed To Unsafe Drinking Water
As many as 63 million people — nearly a fifth of the United States — from rural central California to the boroughs of New York City, were exposed to potentially unsafe water more than once during the past decade, according to a News21 investigation of 680,000 water quality and monitoring violations from the Environmental Protection Agency. The findings highlight how six decades of industrial dumping, farming pollution, and water plant and distribution pipe deterioration have taken a toll on local water systems. (Philip, Sims, Houston and Konieczny, 8/14)

The Associated Press: Researchers To Study Chemical Contamination Of US Waters
University of Rhode Island and Harvard University professors are collaborating through a new research center to study chemicals that have contaminated water at sites nationwide. The chemicals, called perfluorinated chemicals, have been linked to cancer and other illnesses but aren’t federally regulated in drinking water. Water has been contaminated near sites of industrial facilities and U.S. military bases. (McDermott, 8/15)

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