First Edition: October 20, 2014

Today's headlines include a variety of stories about the continuing national response to Ebola and the potential impact that fears of this illness might have on the midterm elections.

Kaiser Health News: What CDC Can Do To Fight Ebola
Kaiser Health News staff writer Julie Rovner reports: “The Ebola epidemic in Africa and fears of it spreading in the U.S. have turned the nation’s attention to the federal government’s front-line public health agency: The Centers for Disease Control and Prevention (CDC). But as with Ebola itself, there is much confusion about the role of the CDC and what it can and cannot do to prevent and contain the spread of disease. The agency has broad authority under federal law, but defers to or partners with state and local health agencies in most cases” (Rovner, 10/20). Read the story. 

Politico Pro: Dems’ Runoff Nightmare: More Obamacare Glitches
The second sign-up season for health care exchanges begins November 15 — a post-election launch that was supposed to insulate Democrats from the politics of another website meltdown. But it’s almost certain that the Senate race in Louisiana will require a runoff in December, and a January runoff is also possible in Georgia. That means residents of the two states will be checking into HealthCare.gov at the exact moment they’re considering their vote — and possibly which party will control the Senate (Cheney and Wheaton, 10/19).

The New York Times: Unable To Meet The Deductible Or The Doctor
Patricia Wanderlich got insurance through the Affordable Care Act this year, and with good reason: She suffered a brain hemorrhage in 2011, spending weeks in a hospital intensive care unit, and has a second, smaller aneurysm that needs monitoring. But her new plan has a $6,000 annual deductible, ... She is skipping this year’s brain scan and hoping for the best. ... About 7.3 million Americans are enrolled in private coverage through the Affordable Care Act marketplaces, and more than 80 percent qualified for federal subsidies to help with the cost of their monthly premiums. But many are still on the hook for deductibles that can top $5,000 for individuals and $10,000 for families (Goodnough and Pear, 10/17).

Politico Pro: Obamacare Termination Issue Could Muddle Renewals
Consumers who already have an Obamacare plan could face a messy situation early next year if they pick a different insurer for their 2015 coverage because HealthCare.gov won’t be telling companies whom to terminate. In some cases, industry sources worry, a person could be double billed for premiums because two carriers have the individual on their books on Jan. 1. Other consumers could be erroneously cut from their plans after Dec. 31 if inaccuracies in the federal exchange database lead to companies getting bad information on renewals, said one insurance official who has been briefed on the issue (Pradhan, 10/17).

Politico: Health Cancellations Ripple In Colorado
More than 22,000 Coloradans were informed in the past month that their health coverage will be canceled at the end of the year, state insurance authorities disclosed this week, a spike in cancellations already roiling the state’s fierce campaigns for the Senate and governor’s seat. Republican Rep. Cory Gardner, who’s running to unseat Democratic Sen. Mark Udall, pounced on the news as evidence that Obamacare is disrupting coverage for Coloradans ... It’s unclear, though, if Obamacare is the reason for the latest wave of canceled plans. The cancellations are nearly all the result of a decision by Humana (Cheney, 10/17).

The Washington Post: 'It's Just Maddening. There's Nothing You Can Do.'
In an obscure corner of the federal bureaucracy, there is an office that is 990,399 cases behind. ... It is bigger even than the infamous backups at Veterans Affairs, where 526,000 people are waiting in line, and the patent office, where 606,000 applications are pending. All of these people are waiting on a single office at the Social Security Administration. Social Security is best-known for sending benefits to seniors. But it also pays out disability benefits to people who can’t work because of mental or physical ailments. And it runs an enormous decision-making bureaucracy to sort out who is truly disabled enough to get the checks — and who is trying to game the systems (Fahrenthold, 10/19).

The Wall Street Journal: Lilly CEO Sees Light After A Difficult Year
Eli Lilly & Co. is deep into what Chief Executive John C. Lechleiter calls the “toughest year” in the drug maker’s 138-year history. Revenue at Lilly has plunged because of generic competition that followed patent expirations for several of its top-selling drugs, including the antidepressant Cymbalta (Loftus, 10/19).

The Wall Street Journal’s Pharmalot: Better Late Than Never: CMS Improves The Doctor Payment Website
Remember how challenging it was to navigate the new government database of payments made by drug and medical-device makers to U.S. doctors? Well, the transparency initiative just became a little easier to use – more than two weeks after the database was posted online (Loftus, 10/17).

Politico Pro: House Dems Want Approval For Surgeon General Pick
More than two dozen House Democrats are calling on the Senate to swiftly approve Vivek Murthy’s nomination to serve as surgeon general to help combat the spread of the deadly Ebola virus in the U.S. Murthy’s nomination got sidelined after Republicans and vulnerable Senate Democrats voiced reservations about the Harvard Medical School physician’s outspoken views on gun violence and public health. But the House Democrats, in a letter set to be released next week, argue that the Obama administration needs a top official in place to help with Ebola response (French, 10/17).

The Wall Street Journal’s Washington Wire: Ebola Furor Renews Sparring Over Surgeon General Nomination
The political furor over the U.S. response to the Ebola outbreak has revived debate over President Barack Obama’s stalled pick for U.S. Surgeon General. Some supporters of the administration have for the past few days been trying to shift the spotlight to opposition to Vivek Murthy, Mr. Obama’s pick for the position, which focuses on public-health issues. Dr. Murthy’s nomination met resistance in March when some Senate Democrats indicated they would not vote for him after his support for gun control drew the opposition of the National Rifle Association. Senate Democratic leaders are still not expected to bring Dr. Murthy up for a vote unless enough lawmakers change their positions to confirm him, aides said. But the public health concerns kindled by the spread of Ebola have generated new sparring over his nomination (Peterson and Radnofsky, 10/17).

Politico: POLITICO Poll: Democrats In Danger Over Ebola
Voters who intend to support Republicans in the most consequential Senate and House elections this November had significantly less confidence in the federal government’s response to the occurrence of Ebola, according to a new POLITICO poll. The survey underscores the dangers for Democrats in the midterms if the Obama administration is perceived as mishandling the government’s reaction to the virus (Shepard, 10/20).

NPR: Will Ebola Impact Midterm Elections?
Weekend Edition Sunday's new segment, "For the Record," kicks off with politics and Ebola. NPR's Rachel Martin asks NPR's Mara Liasson and Dallas columnist J. Floyd about the politics of the disease (10/19).

The Washington Post: Ebola, Islamic State Shift Dynamics For Hagan, Tillis In North Carolina’s Senate Race
For much of the year, the incumbent, Sen. Kay Hagan (D), and her allies had successfully framed the campaign as a referendum on the sharp conservative turn taken by the state legislature under the leadership of Tillis, the House speaker. But in the past few weeks, the conversation has pivoted amid alarming headlines about terrorism and a virulent epidemic, further tightening what is expected to be the most expensive Senate race in U.S. history. … For his part, he spent most of his day-long swing through the state pressing the argument that Hagan operates as an extension of Obama. He ticked off a series of issues, such as Obamacare and veterans’ care, in which he said the administration — and the senator — had failed. At every stop, he added two new items on the list: the Islamic State and Ebola (Gold, 10/19).

Los Angeles Times: Costly, Nasty Battle Rages In San Diego Race For Congress
In its third editorial endorsing Republican congressional candidate Carl DeMaio over Democratic incumbent Scott Peters, the U-T San Diego newspaper had one description of DeMaio that not even his many critics could dispute: "One of a kind." DeMaio's hard-charging style, combined with his anti-Washington pledge to "Fix Congress First," has turned the 52nd Congressional District race into one of the tightest and costliest in the country. ... Local television is filled with attack ads. Peters warns that DeMaio plans to cut student loans. DeMaio says he is a big supporter of student loans and Medicare and that Peters represents everything that is wrong with politics: officeholders who are too comfortable with the status quo (Perry, 10/18).

The Washington Post: Gubernatorial Races Poised To Make History In Two Weeks
You wouldn’t know it by following the Senate-control-centric coverage of the midterm elections emanating from Washington, but we could well be headed toward a historic gubernatorial election in 15 days. Not since 1984 have more than six sitting governors lost in any one election. But, 30 years after that gubernatorial carnage, a look at this year’s races puts 11 incumbents in various levels of peril — suggesting that history may be in the making (Cillizza, Blake and Sullivan, 10/19). 

The Washington Post: Pentagon Plans Ebola Domestic-Response Team Of Medical Experts To Aid Doctors
The Pentagon announced Sunday that it will create a 30-person team of medical experts that could quickly leap into a region if new Ebola cases emerge in the United States, providing support for civilian doctors who lack proficiency in fighting the deadly virus (Kane and Ellis Nutt, 10/19).

The Washington Post: Obama: ‘We Can’t Give In To Hysteria Or Fear’ Of Ebola
As Ebola fears have spread, some urgent-care clinics have taken steps to identify red flags, such as recent travel to West Africa, before patients ever set foot in the clinic. AFC/Doctors Express, a national chain of more than 130 urgent-care clinics, with facilities in Alexandria, Va., Woodbridge, Va., Edgewater, Md., and Towson, Md., fields some of its patient calls through a national call center that’s designed to screen symptoms before patients show up to see a doctor. On Friday, the call center developed a new Ebola fact sheet and script to ask patients about their travel history, said Glenn Harnett, the chief medical officer for AFC/Doctors Express (Jaffe and Brittain, 10/18).

The Wall Street Journal: New Ebola Guidelines For Hospitals To Require Full Body Cover
New, more stringent hospital guidelines for treating Ebola patients will require full body coverings and mandate that health-care workers be monitored while putting on and taking off protective garb, a top U.S. health official said. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health, said the new guidelines will be “much more stringent” and require that no skin be exposed (Barnes, 10/19).

NPR: Dallas Hospital Deals With Aftermath Of Ebola Missteps
Authorities in Texas are working to limit travel by health workers who may have been exposed to Ebola. Meanwhile, the hospital at the center of the first cases in the U.S. is trying to move forward (Goodwyn, 10/18).

The Wall Street Journal: Why The Work Of Dr. Nancy J. Sullivan Could Be Key To A Potential Ebola Vaccine
The world had little interest in Ebola in 1997, which is why cell biologist Nancy J. Sullivan thought she might be able to make a mark. Today, if the scientific world is to have an answer to the world’s severest Ebola outbreak, Dr. Sullivan’s work is likely to be at its center (Burton, 10/19).

Los Angeles Times: ‘Ebola Czar' Brings Decades Of Washington Experience
The man tapped to be the country’s “Ebola czar” is a veteran Washington advisor and Democratic strategist who will oversee a multi-agency response to the outbreak in West Africa and the U.S. cases, the White House announced Friday. In a change from a career spent mainly behind the scenes, Ron Klain becomes the Obama administration's point person leading a complicated and highly-visible government Ebola strategy (Hansen, 10/17).

The Associated Press: Ebola 'Czar' Knows Washington, But Not Medicine
[Klain] does have a wealth of experience managing unruly federal bureaucracies in times of crisis. The White House says that makes him the perfect candidate to shepherd the government's response to a deadly, growing outbreak. ... Under immense pressure to step up his response, Obama turned to Klain on Friday. He's being asked to synchronize an alphabet blizzard of federal agencies: the CDC, NIH, HHS, DHS, FDA and DOD, to name a few (Lederman, 10/16).

Kaiser Health News also tracked weekend headlines regarding the Obama administration’s appointment of an Ebola czar. 

The New York Times: Mental Health Issues Put 34,500 On New York’s No-Guns List
A newly created database of New Yorkers deemed too mentally unstable to carry firearms has grown to roughly 34,500 names, a previously undisclosed figure that has raised concerns among some mental health advocates that too many people have been categorized as dangerous. The database, established in the aftermath of the mass shooting in 2012 at the Sandy Hook Elementary School in Newtown, Conn., and maintained by the state Division of Criminal Justice Services, is the result of the Safe Act. ... The law, better known for its ban on assault weapons, compels licensed mental health professionals in New York to report to the authorities any patient “likely to engage in conduct that would result in serious harm to self or others" (Hartocollis, 10/19).

The New York Times: Doctor’s Letter Spells End of Job For Pregnant Employee
This month marks the first anniversary of the Pregnant Workers Fairness Act, which was signed into law by former Mayor Michael R. Bloomberg on Oct. 2, 2013. The law, which went into effect in January, represents a big step forward for working women. It requires employers to make reasonable accommodations for pregnant workers — such as providing rest and water breaks, modified work schedules and light duty – so long as the accommodations don’t cause undue hardship for the employer. Makes sense, right? It’s actually critical, particularly for low-income women who sometimes get pushed out of their jobs – and into poverty – when they become pregnant (Swarns, 10/17).

Chillicothe Gazatte/USA Today: Medicare Patients Pay More At Rural Hospitals
ECGs and nine other frequently provided outpatient services cost from two to six times more for Medicare patients at the nation's rural, critical access hospitals compared to other hospitals, according to a report by the U.S. Department of Health and Human Services' Inspector General (Balmert, 10/20). 

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