KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: July 17, 2017

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

Kaiser Health News: Analysis: Senate’s Latest Health Blueprint Cuts Costs At The Expense Of Chronically Ill
The latest Senate health proposal reins in costs by effectively splitting the individual insurance market, with healthy people diverted into stripped-down plans and chronically ill individuals left with pricey and potentially out-of-reach options, insurance analysts said. This draft — a fresh attempt by the Republican Party to undo the Affordable Care Act — injects more uncertainty into plans for people with preexisting conditions such as cancer, asthma, diabetes or other long-term ailments. Those people, insured through ACA marketplaces now, could be more isolated than in an earlier version of the Senate bill. (Hancock, 7/17)

Kaiser Health News: Podcast: What The Health? Senate Health Bill 2.0. Still On Life Support
Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Sarah Kliff of Vox.com and Margot Sanger-Katz of The New York Times discuss the changes to the proposed Senate health bill, and whether they can win the 50 votes needed to pass it. Plus, for “extra credit,” the panelists recommend their favorite health stories of the week they think you should read, too. (7/14)

Kaiser Health News: Calif. Hits Nerve By Singling Out Cardiac Surgeons With Higher Patient Death Rates
Michael Koumjian, a heart surgeon for nearly three decades, said he considered treating the sickest patients a badge of honor. The San Diego doctor was frequently called upon to operate on those who had multiple illnesses or who’d undergone CPR before arriving at the hospital. Recently, however, Koumjian received some unwelcome recognition: He was identified in a public database of California heart surgeons as one of seven with a higher-than-average death rate for patients who underwent a common bypass procedure. (Gorman, 7/17)

The New York Times: A Top Republican Vows A Vote On Health Care, But Uncertainty Reigns
A top Senate Republican vowed on Sunday to bring the party’s health care bill to a vote as soon as possible, even as detractors said they would use a delay caused by the absence of Senator John McCain to mobilize further opposition to the measure. “I believe as soon as we have a full contingent of senators, that we’ll have that vote,” the No. 2 Senate Republican, John Cornyn of Texas, said on NBC’s “Meet the Press.” (Pear, 7/16)

The New York Times: McCain’s Surgery May Be More Serious Than Thought, Experts Say
The condition for which Senator John McCain had surgery on Friday may be more serious than initial descriptions have implied, and it may delay his return to Washington by at least a week or two, medical experts said on Sunday. The Senate majority leader, Mitch McConnell, has already announced that votes on a bill to dismantle the Affordable Care Act will not begin until Mr. McCain’s return. (Grady and Pear, 7/16)

The Wall Street Journal: GOP Push To Pass Health-Care Law Faces New Setback
The delay prolongs the uncertainty over the bill’s prospects. GOP leaders have pursued a fast-paced timeline, as health-policy changes are often controversial. Sen. John Cornyn, a member of Senate GOP leadership, told reporters last month that passing the bill is “not going to get any easier” with time. Another GOP senator, Lindsey Graham of South Carolina, said the bill “is not like fine wine; it doesn’t get better with age.” (Tau, Radnofsky and Peterson, 7/16)

The Washington Post: GOP Opponents To Senate Health-Care Bill See Vote Delay As An Advantage
A vocal conservative opponent of the measure, Sen. Rand Paul, predicted the delay would strengthen critics’ position by giving them more time to mobilize against the bill. “The longer the bill is out there, the more conservative Republicans are going to discover it is not repeal,” Paul (R-Ky.) said Sunday in an interview with CBS’s “Face the Nation.” (Viebeck, 7/16)

USA Today: Republican Health Care Bill Faces Perilous Path After Vote Delay
Republicans already lost two of their members on the revised bill – the moderate Collins and Kentucky conservative Sen. Rand Paul, who said they would vote against a procedural motion to bring the bill to the floor – and can’t afford to lose a third. Without McCain’s vote in favor, the bill does not have enough support to pass. (Collins and Sullivan, 7/16)

Politico: Who’s In And Who’s Out: McConnell’s Twisting Path To 50
Moderate senators like Ohio’s Rob Portman, Alaska’s Lisa Murkowski and Nevada’s Dean Heller are still on the fence about the bill, worried about its deep cuts to Medicaid. At the other end of the spectrum, conservative Sen. Mike Lee is undecided even after GOP leaders tried to include his idea for rolling back more of Obamacare’s regulations. (Cancryn, 7/15)

The Associated Press: Nevada Sen. Dean Heller Is The Man To Watch On Health Bill
Health care legislation is hanging by a thread in the Senate, and no one is under more pressure than Republican Sen. Dean Heller of Nevada. Heller was already seen as the most endangered GOP incumbent senator in next year's midterm elections. He is the only one running for re-election in a state President Donald Trump lost to former Democratic presidential candidate Hillary Clinton. (Werner and Noon, 7/14)

Los Angeles Times: In His Small Hometown, Arizona's Jeff Flake Faces Perils And Pressure Of Senate Healthcare Debate
Ron McArthur is a man with big plans. As head of the chief medical provider in this rural slice of eastern Arizona, McArthur firmly believes what’s good for Summit Healthcare is good for communities tucked in the foothills of the White Mountains. “We’re the economic engine,” he said. “We sponsor everything, we’re the biggest employer, we offer the highest-paying jobs.” (Barabak, 7/17)

Politico: Meet Obamacare Repeal’s Top Salesman
Senate Republicans are in a grumpy mood these days. Then there’s John Cornyn, who’s almost unfailingly optimistic about the GOP’s chances of passing its Obamacare repeal bill despite the increasingly long odds. “I mean, if you’re going to be in a leadership role, you don’t have the luxury of public hand-wringing,” Cornyn, the Senate majority whip, said in a recent interview in his Capitol office. (Kim and Everett, 7/16)

Politico: How The White House And Republicans Underestimated Obamacare Repeal
The longer Republican efforts to repeal Obamacare flounder, the clearer it becomes that President Donald Trump’s team and many in Congress dramatically underestimated the challenge of rolling back former President Barack Obama’s signature achievement. The Trump transition team and other Republican leaders presumed that Congress would scrap Obamacare by President’s Day weekend in late February, according to three former Republican congressional aides and two current ones familiar with the administration’s efforts. (Cook and Everett, 7/17)

The New York Times: Governors Give Chilly Reception To Health Bill Push
A handful of Republican governors rebuffed on Saturday an attempt by their Democratic counterparts to issue a joint statement from the nation’s governors expressing opposition or even concern about the Senate health care bill. But a smaller, bipartisan group of influential governors still may release a statement of their own in the coming days, a move that would greatly imperil passage of a measure that is already listing. While Republican governors stopped well short of declaring common cause with Democrats on health care, state executives from both parties gave a brusque reception to Trump administration officials who trekked to Rhode Island to lobby governors for their support. (Martin and Burns, 7/15)

The Washington Post: White House Launches Aggressive Push To Flip GOP Governors Opposed To Senate Health Bill
Despite the administration’s sales pitch, however, four influential governors reiterated their concerns about the bill’s impact on their states’ most vulnerable individuals — underscoring the challenge facing the White House and Senate Republicans as they seek to fulfill a seven-year GOP promise to undo the Affordable Care Act (ACA). “I’ve still got to come back to my concerns with regard to the Medicaid population,” said Gov. Brian Sandoval (R-Nev.) on his way to a private session with Vice President Pence here at the summer meeting of the National Governors Association. Pence had earlier delivered a detailed speech to the entire group defending the bill. (Sullivan, Eilperin and Balz, 7/14)

The Washington Post: Nevada Gov. Brian Sandoval Still Doesn’t Support The Senate Health-Care Bill. That’s Big Trouble For Republicans.
Among the 32 state executives who attended the National Governors Association summer meeting here this weekend, no one drew more attention and interest than Sandoval, a square-jawed 53-year-old with neatly parted dark hair, a made-for-TV smile and a political disposition that is the antithesis of President Trump. All weekend, he has been besieged — by reporters taking his temperature and by administration officials, including Vice President Pence, trying to persuade him that the Senate bill would not hurt his Nevada constituents despite its deep federal spending cuts to Medicaid. (Sullivan and Balz, 7/15)

The Associated Press: White House Pitches Health Bill To Skeptical US Governors
U.S. Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma made their pitch Saturday morning during a closed-door meeting of the bipartisan National Governors Association. Vice President Mike Pence also met several of the governors privately after his public address at the Rhode Island conference on Friday. (7/15)

The New York Times: In Clash Over Health Bill, A Growing Fear Of ‘Junk Insurance’
Julie Arkison remembers what it was like to buy health insurance before the Affordable Care Act created standards for coverage. The policy she had was from the same insurer that covers her now, but it did not pay for doctor visits, except for a yearly checkup and gynecological exam. “I couldn’t even go to my regular doctor when was I sick,” said Ms. Arkison, 53, a self-employed horseback-riding teacher in Saline, Mich. (Abelson, 7/15)

The Wall Street Journal: Senate Health Bill Frays Republicans
Insurers have worried that under the Cruz proposal, the health market would be split in two. Healthy and younger people would flock to cheaper, less comprehensive plans, while people with pre-existing conditions who need more comprehensive coverage could have to pay far more. That has alarmed centrist GOP senators who want to maintain protections for people with pre-existing conditions. And although conservatives sought the Cruz measure, its current version has left them divided because of a change in the way the market where people buy insurance when they don’t get coverage on the job would be structured. (Armour and Peterson, 7/14)

Los Angeles Times: Obamacare Repeal Bills Could Put Coverage Out Of Reach For Millions Of Sick Americans
“The fundamental guarantee at the heart of the Affordable Care Act was that people who are sick can get insurance at the same price as everyone else,” said Larry Levitt, an insurance market expert at the nonprofit Kaiser Family Foundation. “The House and Senate replacement bills move the system back to a place where healthy and sick people are treated very differently.” (Levey, 7/16)

The Associated Press: Trump's No 'Dying In The Streets' Pledge Faces Reality Check
President Donald Trump has often said he doesn't want people "dying in the streets" for lack of health care. But in the United States, where chronic conditions are the major diseases, people decline slowly. Preventive care and routine screening can make a big difference for those at risk for things such as heart problems and cancer, especially over time. (Alonso-Zaldivar, 7/15)

The Associated Press: Health Plan Hinges On The Young, But They're A Tough Sell
Julian Senn-Raemont isn't convinced he needs to buy health insurance when he loses coverage under his dad's plan in a couple of years — no matter what happens in the policy debate in Washington, or how cheap the plans are. The 24-year-old musician hasn't known a world without a health care safety net. But he hates being forced by law to get coverage, and doesn't think he needs it. (Johnson, 7/17)

The Wall Street Journal: Health-Law Taxes Divide The GOP, Signaling A Shift
Republican efforts to pass a health-care bill have revealed a party fissure on tax policy with potentially far-reaching repercussions. In his latest attempt to rewrite President Barack Obama’s signature health-care law, Senate Majority Leader Mitch McConnell (R., Ky.) retained a 3.8% investment-income tax and a 0.9% payroll tax that apply to individuals earning more than $200,000 and married couples earning more than $250,000. (Rubin, 7/17)

The Associated Press: New GOP Health Care Bill Will Determine Winners, Losers
Republicans' latest health care plan would create winners and losers among Americans up and down the income ladder, and across age groups.It would give consumers more responsibility for their insurance choices, a goal long held by conservatives who argue that's key to a true health care market. Younger adults and healthy people in the solid middle class may find more agreeable options. But low-income people may not be able to afford coverage, along with older and sicker adults. (7/15)

The Wall Street Journal: States To Health Insurers: Please Come Back
Nevada officials were stunned last month to learn that Anthem Inc., the only insurer selling plans statewide through the insurance exchange, was planning to pull back next year, leaving consumers in most counties with no way to get plans under the Affordable Care Act. “It felt like a gut punch,” says Heather Korbulic, executive director of Nevada’s insurance exchange, where consumers buy ACA coverage online. When she learned of the situation from insurer filings, she says, she blurted out loud: “Holy shit, what are we going to do?” Nevada officials quickly began pushing to solve the problem. (Wilde Mathews, 7/14)

The Washington Post: In An Arid, Lonely Stretch Out West, The Health Coverage That Bloomed Is Now At Risk
In this speck of high desert, along a stretch of highway that Life magazine once called the loneliest road in America, the only doctor in town comes just one day a week. In the past few years, though, health insurance has arrived in force. The county that includes Silver Springs now has more than 3,500 additional residents on Medicaid, because Nevada’s governor was the first Republican in the country to expand the program through the Affordable Care Act. Nearly 1,400 others have private plans through the law and the Silver State Health Insurance Exchange. (Goldstein, 7/16)

Politico: How Hospitals Got Richer Off Obamacare
A decade after the nation’s top hospitals used all their advertising and lobbying clout to keep their tax-exempt status, pointing to their vast givebacks to their communities, they have seen their revenue soar while cutting back on the very givebacks they were touting, according to a POLITICO analysis. (Diamond, 7/17)

Politico: How The Cleveland Clinic Grows Healthier While Its Neighbors Stay Sick
On the Cleveland Clinic’s sprawling campus one day last year, the hospital’s brain trust sat in all-white rooms and under soaring ceilings, looking down on a park outside and planning the next expansion of the $8 billion health system. A level down, in the Clinic’s expansive alumni library, staff browsed century-old texts while exhausted doctors took naps in cubbies. And in the basement, a cutting-edge biorobotics lab was simulating how humans walk using a cyborg-like meld of metallic and cadaver parts. (Diamond, 7/17)

Los Angeles Times: One Child, A $21-Million Medical Bill: How A Tiny Number Of Patients Poses A Huge Challenge For Medi-Cal
Somewhere in California, one child’s medical expenses in 2014 totaled $21 million — a bill covered entirely by Medi-Cal, the state’s version of Medicaid. The child’s condition is not known. But the cost of care was mentioned in recent Twitter and Facebook posts by Jennifer Kent, head of the state Department of Health Care Services, which runs Medi-Cal. (Karlamangla, 7/16)

Politico: White House Announces New Theme Weeks Amid Health Care Bill Uncertainty
With Republicans’ health care bill in jeopardy, the White House is once again turning to a series of unrelated themed weeks to organize President Donald Trump’s schedule. ... Administration officials bristled at the notion that the themed weeks could distract from the debate over repealing and replacing Obamacare, one of the president’s biggest policy priorities. (Restuccia, 7/16)

NPR: Rural Arizona's Doctor Shortage A Symptom Of 'Forgotten America'
For Heather Gijanto, going to the doctor means taking a day off work and driving at least 60 miles round trip from her home in McNeal, Ariz., to the town of Bisbee. And that is assuming there is a primary care doctor available in Bisbee to get her in. "You select one doctor and then you find out a few months later that that doctor is no longer going to be available," Gijanto says. "So then you have to start the whole process over again. And then you find that doctor and, for whatever reason, that doctor leaves as well." (Siegler, 7/14)

Los Angeles Times: An Overdose, A Young Companion, Drug-Fueled Parties: The Secret Life Of Then-USC Med School Dean
In USC’s lecture halls, labs and executive offices, Dr. Carmen A. Puliafito was a towering figure. The dean of the Keck School of Medicine was a renowned eye surgeon whose skill in the operating room was matched by a gift for attracting money and talent to the university.There was another side to the Harvard-educated physician. (Pringle, Ryan, Elmahrek, Hamilton and Parvini, 7/17)

The New York Times: ‘To The Bone’ Opens Frank Dialogue On Eating Disorders: ‘They Steal Your Voice’
When Marti Noxon set out to make “To the Bone,” a film about a 20-year-old battling an eating disorder, she initially faced the question: Was the topic too niche? The answer came in the form of a rousing premiere in January at the Sundance Film Festival, Netflix’s reported $8 million purchase of the film, a trailer that went viral with 54 million views in the first week and arguments over whether it glamorized excessive thinness. The film debuted on Netflix on Friday. (Minsberg, 7/14)

NPR: Artificial Sweeteners Don't Help With Weight Loss
The theory behind artificial sweeteners is simple: If you use them instead of sugar, you get the joy of sweet-tasting beverages and foods without the downer of extra calories, potential weight gain and related health issues. In practice, it's not so simple, as a review of the scientific evidence on non-nutritive sweeteners published Monday shows. (Hobson, 7/17)

NPR: High Alzheimer's Rates Among African-Americans May Be Tied To Poverty
Harsh life experiences appear to leave African-Americans vulnerable to Alzheimer's and other forms of dementia, researchers reported Sunday at the Alzheimer's Association International Conference in London. Several teams presented evidence that poverty, disadvantage and stressful life events are strongly associated with cognitive problems in middle age and dementia later in life among African-Americans. (Hamilton, 7/16)

NPR: 'Dirt Is Good': New Book Explores Why Kids Should Be Exposed To Germs
As a new parent, Jack Gilbert got a lot of different advice on how to properly look after his child: when to give him antibiotics or how often he should sterilize his pacifier, for example. After the birth of his second child, Gilbert, a scientist who studies microbial ecosystems at the University of Chicago, decided to find out what's actually known about the risks involved when modern-day children come in contact with germs. (Garcia-Navarro, 7/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.