KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Economic Theory Shows Health Law’s Taxes Will Affect Jobs; No Indication That Part-Time Jobs Are Increasing; Doctors ‘Ditching’ Medicare?

The New York Times: Economix: Obamacare Vs. Romneycare: The Labor Impact
The Affordable Care Act was intended to expand the fraction of the United States population covered by health insurance. The law includes taxes on employers and various implicit taxes on employees that go into effect over the next two years. Economic theory suggests that such taxes will contract the labor market in an amount commensurate with the amount of the new taxes (Casey B. Mulligan, 9/4).

The New York Times: Economix: Testing A Premise On The Health Care Law And Part-Time Work
Since the Affordable Care Act requires businesses with at least 50 full-time workers to provide them with coverage (or it will, when the employer mandate kicks in a year from now), critics claim that it is prompting employers to shift to more part-time jobs. But as I have noted in various postings, there is no evidence to back up that claim — in fact, both involuntary and overall part-time work are declining as a share of all jobs (Jared Bernstein, 8/3).

Forbes: How Rick Perry's And Bobby Jindal's Medicaid Snubs Boost Private Insurance Costs
Health insurance rates for individuals purchasing private coverage could jump 8 to 10 percent in Louisiana, Florida and Texas where state political leaders have decided against expanding the Medicaid health insurance program for the poor under the Affordable Care Act, new research indicates. In a new study from the nonprofit research organization RAND Corp., researchers said the lack of an expanded Medicaid program will force more lower income people into the individual insurance market via exchanges created by the health law to provide more private coverage (Bruce Japsen, 9/1).

The New Republic: Read: These Documents Show What An Attempt To Sabotage Obamacare Looks Like
Republicans may have found a new way to undermine Obamacare: By harassing the organizations that are supposed to help people get health insurance. Last week, Republicans on the House Energy and Commerce Committee sent letters to at least some of the 105 organizations that, earlier this month, received federal grants to serve as "navigators" for Obamacare (Jonathan Cohn, 9/2). 

USA Today: Common Ground: Will ObamaCare Crash Or Cruise?
The Affordable Care Act has yet to prove itself the best solution to health care reform. Cal Thomas is a conservative columnist. Bob Beckel is a liberal Democratic strategist. But as longtime friends, they can often find common ground on issues that lawmakers in Washington cannot (Cal Thomas and Bob Beckel, 9/3).

Los Angeles Times: Five Ways To Think About The U.S. Debt Limit
In recent budget talks between the White House and congressional Republicans, changes to both Social Security and Medicare have been proposed. ... The budget negotiators also discussed a "complete restructuring of Medicare," according to the Washington Post. It's not clear why anything of the sort is necessary. Medicare is the most efficient provider of healthcare we have, and its rate of cost growth has been coming down sharply in recent years. Obama still hankers after a "grand bargain" encompassing the debt limit, the budget and other fiscal matters, so the chance that there will be disguised negotiations over the debt limit still lurks in the wings (Michael Hiltzik, 9/3).

Los Angeles Times: Who May Perform Abortions
Under California law, abortions may only be performed by medical doctors. But a new bill, which just won approval in the Legislature, would allow certified nurse midwives, nurse practitioners and physician assistants who complete special training to perform certain routine first trimester abortions. The bill, AB 154, by Assembly Majority Leader Toni Atkins (D-San Diego), is a reasonable and sensible measure that Gov. Jerry Brown should sign (9/3). 

The Washington Post: Long-Term, Who Will Take Care Of You?
During the discussion, a woman asked a question that so many others are asking. She wanted to know what to do about her aging parents. They have little money and many health issues. She didn't think they could afford to continue living on their own. The woman is sandwiched between taking care of her children and her parents. Her financial resources can stretch only so far (Michelle Singletary, 9/3).

The Fiscal Times Are Doctors Really Ditching Medicare?
So are doctors really abandoning their elderly patients? While many are certainly not taking Medicare patients anymore, the big picture is much more nuanced. First, a little math helps clarify what's really been happening. There are about 685,000 physicians in the U.S. who accept Medicare patients. Last year, according to the Centers for Medicare and Medicaid Services (CMS), some 9,539 doctors chose to opt out of Medicare. That's up from 3,700 in 2009, but it's still less than 2 percent, which is hardly a mass exodus (John F. Wasik, 09/04). 

Minneapolis Star Tribune: Not Too Many Sure Things At MNsure's New Hot Line
The "trained service representative" answered my call to MNsure’s new customer contact center within seconds. It was 8:24 a.m. on Tuesday, and as it turns out, I was one of the first consumers to ask questions about how the Affordable Care Act (or as I like to call it, Romneycare) will roll out (Jon Tevlin, 9/3).

San Francisco Chronicle: AMA Sells Its Members' Most Intimate Data
As of last month, physicians will have to think twice about attending a pharmaceutical-industry-sponsored lunch. August marks the implementation of the Affordable Care Act's Sunshine Rule, which requires drug and device manufacturers to disclose contributions of more than $10 to physicians (Doug Jacobs, Shawn Gogia and Joshua Lang, 9/4).

Forbes: Is 'No Worse Than Placebo' Good Enough For New Diabetes Drugs?
The state of diabetes drugs has gotten to the point where it is good news that a drug does not produce worse outcomes than a placebo. I am not kidding. ... Yesterday the New England Journal of Medicine published two trials, each testing whether a diabetes drug increased the risk of heart attacks and death from heart disease. ... But the message that these studies did not show that the drugs increased the risk of heart attacks, death from heart disease or stroke should not obscure the point that we hope that these drugs actually improve outcomes. ... We need comparative effectiveness studies of different regimens designed to determine how they fare on patient outcomes. Diabetes affects about 7% of our population and pharmaceutical sales are in the billions of dollars. Rather than mandating narrow studies of cardiovascular studies, we should be encouraging studies that let us know which regimen is best for which patients, based on what they actually do for patients (Harlan Krumholz, 9/3).

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