KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: January 31, 2013

Today's headlines include reports on a new health law final rule issued by the Internal Revenue Service eligibility and affordability standards for insurance subsidies.

Kaiser Health News: Fed Economist Steps Into Dispute On Geographic Differences In Health Spending
Kaiser Health News staff writer Jordan Rau reports: "An economist at the Federal Reserve has restoked the debate over the causes of regional differences in Medicare spending, and her analysis disputes some of the thinking behind a number of policy changes in the 2010 health law" (Rau, 1/30). Read the story.

Kaiser Health News: Manhattan's Bellevue Hospital Is Back, But Changed, After Sandy
WNYC's Fred Mogul, working in partnership with Kaiser Health News and NPR, reports: "When a ferry crashed in lower Manhattan earlier this month, ambulances took dozens of people to hospitals around Manhattan. Bellevue Hospital took in 31 passengers who all had minor injuries. Despite their bruises and bandages, something was missing: the most seriously hurt patients from the crash. Dr. Suzi Vassallo said that's because Bellevue currently can't handle serious traumatic injuries. Hurricane Sandy closed Bellevue, and it re-opened in December, but doing only partial duty" (Mogul, 1/30). Read the story.

Kaiser Health News: Capsules: Some Families Will Be Ineligible For Insurance Subsidies Under Final Rule; A Wish List For Medicare
Now on Kaiser Health News' blog, Julie Appleby reports on a newly issued health law final rule: "But the rule defines the standard for affordability more narrowly than most consumer groups had hoped — as an amount less than 9.5 percent of household income to cover just that employee's share of premium costs, not on what he or she must pay to cover their entire family, which is generally more expensive" (Appleby, 1/30).

Also on Capsules, Mary Agnes Carey reports on what a group of Medicare experts consider to be their wish list: "The three experts want to see a permanent fix for the payment formula for doctors. That formula, called the sustainable growth rate, or SGR, has threatened large payment cuts nearly every year since being implemented and Congress has repeatedly stepped in to stop it. And all said it's high time Congress confirms a CMS administrator" (Carey, 1/30). Check out what else is on the blog.

The New York Times: Federal Rule Limits Aid To Families Who Can’t Afford Employers Health Coverage
The Obama administration adopted a strict definition of affordable health insurance on Wednesday that will deny federal financial assistance to millions of Americans with modest incomes who cannot afford family coverage offered by employers. In deciding whether an employer's health plan is affordable, the Internal Revenue Service said it would look at the cost of coverage only for an individual employee, not for a family (Pear, 1/30).

The Wall Street Journal: Workers' Children Won't Get Subsidies
The decision, announced by the Obama administration on Wednesday, means some low-income Americans whose employer-plan premiums are beyond their means won't be eligible for the main perk of the law. Several provisions are behind the wrinkle (Radnofsky, 1/30).

The Associated Press/Washington Post: IRS: Some Families Who Can't Afford Coverage On The Job Can't Get Govt. Aid To Buy Health Plans
Some families could get priced out of health insurance due to what's being called a glitch in President Barack Obama's overhaul law. IRS regulations issued Wednesday failed to fix the problem as liberal backers of the president's plan had hoped (1/30).

The Washington Post: Medicare To Adjust Payment For Dialysis Drugs After Overspending Millions
The Medicare system is recalculating how much it will reimburse hospitals and clinics for the drugs used to treat dialysis patients after federal auditors found recently that the program could save as much as $880 million annually. An analysis by The Washington Post in August showed that the government was overspending by hundreds of millions for just one group of those drugs (Whoriskey, 1/30).

The Associated Press/Washington Post: Medicare Expands Competitive Bids For Medical Equipment; Big Savings Seen For Some Seniors
Savings are also coming for many patients who rent home oxygen gear, hospital beds, wheelchairs and other equipment. Medicare deputy administrator Jonathan Blum said Wednesday its due to competitive bidding making inroads against wasteful spending (1/30).

The Wall Street Journal: Some Unions Grow Wary Of Health Law They Backed
Labor unions enthusiastically backed the Obama administration's health-care overhaul when it was up for debate. Now that the law is rolling out, some are turning sour. Union leaders say many of the law's requirements will drive up the costs for their health-care plans and make unionized workers less competitive. Among other things, the law eliminates the caps on medical benefits and prescription drugs used as cost-containment measures in many health-care plans. It also allows children to stay on their parents' plans until they turn 26 (Adamy and Trottman, 1/30).

Politico: Brady To Take On Medicare Challenges
Congress has done little but bicker over Medicare for the past few years, but Rep. Kevin Brady still thinks he has a shot at fixing the program now that he’s leading a powerful health panel. As newly installed Health Subcommittee chairman for the Ways and Means Committee, the Texas Republican is already working on two projects that lawmakers have pushed to the back burner for years because they were too contentious to solve (Cunningham, 1/31).

The New York Times: Making 'Every Patient Counts' A Business Imperative
Drug companies are fond of saying that every patient counts, but in the world of orphan diseases, entire business plans are built around the idea (Thomas, 1/30).

The New York Times: Federal Agents Raid Offices Of Donor Linked To Senator Menendez
The Federal Bureau of Investigation on Tuesday raided the offices of a prominent South Florida eye surgeon who is a wealthy Democratic Party donor with close ties to Senator Robert Menendez of New Jersey (Robles, 1/30).

USA Today/The Cincinnati Enquirer: Ohio Governor Weighs Medicaid Expansion
Ohio could be among a growing contingent of Republican-led states leaning toward expanding Medicaid coverage for hundreds of thousands of low-income residents. In an interview with The Cincinnati Enquirer this week, Ohio Gov. John Kasich hinted he would call for expanding the joint federal-state health care program for poor and disabled in his pending two-year budget proposal, which is due Monday (Bernard-Kuhn, 1/30).

Los Angeles Times: Beach Cities Are Getting Healthier, Data Show
A comprehensive effort to improve the health of residents living in the beach cities is doing just that, according to new data released Wednesday. Beginning in 2010, Redondo Beach, Manhattan Beach and Hermosa Beach started making changes in homes, workplaces and schools to improve the well-being of people living in the region. They revamped restaurant menus, started "walking school buses" for children and created neighborhood gardens. Hermosa Beach passed an anti-smoking ordinance and the beach cities began working on adding bike lanes (Gorman, 1/30).

Los Angeles Times: County Health Clinic To Open In Skid Row Apartment Building
Recognizing the high cost of treating homeless patients, Los Angeles County plans to open a health clinic inside a skid row apartment building. Residents of the 102-unit building, scheduled to open this summer on 6th Street, will be carefully chosen based on their health needs and their regular use of the emergency healthcare system (Gorman, 1/30).

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