KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Baucus Applauds ‘Listening To Customers’ On Employer Mandate Delay; Unions ‘Wake Up’ To Problems With Health Law; Medicare’s ‘Two Midnights’ Rule

Politico: Obamacare Provision's Timely Delay
Any successful business leader will tell you the importance of listening to customers, gathering their input and suggestions and always putting them first. That lesson was not lost on the Obama administration earlier this month when it correctly decided to push back the implementation of the Affordable Care Act's employer responsibility provision — the employer mandate — until 2015. I'm sure this was a tough call, but it was the right one. It shows the administration is listening to the business community and working to address its concerns, as well as the concerns of Congress (Sen. Max Baucus, D-Mont., 7/17).

The New York Times: The Conscience Of A Liberal: Obamacare Is The Right's Worst Nightmare
News from New York: It looks as if insurance premiums on the individual market are going to plunge thanks to Obamacare. This shouldn't come as a surprise; in fact, the New York experience perfectly illustrates why Obamacare had to look the way it does. And it also illustrates why conservatives should be terrified about this legislation, as it takes effect. Americans may have had a lot of misgivings in advance, thanks to vast, deliberately spread misinformation. But I agree with Matt Yglesias — unless the GOP finds even more ways to sabotage the plan, this thing is going to work, it's going to be extremely popular, and it's going to wreak havoc with conservative ideology (Paul Krugman, 7/17).

The New York Times' Five Thirty Eight: In Public Opinion On Abortion, Few Absolutes
As with so many other areas this blog covers, abortion is one in which selective readings of the polls can seem to prove opposite conclusions. After writing about abortion and public opinion in Sunday's Times – arguing that the issue does not benefit Democrats as much as other high-profile subjects, like immigration, guns, taxes and same-sex marriage – I wanted to dig more deeply into the polls and their trend lines. For all the assertions that advocates make about public opinion, I think that a few consistent messages emerge (David Leonhardt, 7/17). 

Los Angeles Times: New Attack On Obamacare Would Make Insurance Costlier
House Republicans continued their crusade to dismantle Obamacare on Wednesday, but an announcement from New York Gov. Andrew Cuomo should have stopped them in their tracks. The fact that it didn't shows that Republican lawmakers are so determined to undermine the law, they don't care what might happen to their constituents (Jon Healey, 7/17). 

The Wall Street Journal: Obamacare's Coalition Begins To Fracture
The letter was unusually harsh. Addressed to Senate Majority Leader Harry Reid and House Minority Leader Nancy Pelosi, it was really intended for President Barack Obama. The letter was not from Mr. Obama's GOP adversaries but from the presidents of three powerful unions. ... Union leaders are correct that ObamaCare "creates an incentive to keep employees' work hours below 30 hours a week." After all, employers can avoid a $2,000-per-worker fine if they don't provide insurance as long as employees work fewer than 30 hours a week (Karl Rove, 7/17). 

The Wall Street Journal: Big Labor Wakes Up To Obamacare
Every revolution devours its children, but it's still surprising to see some of Obamacare's keenest boosters deny paternity so soon after the birth. Witness the emotional volte-face from three top union leaders, warning that the program will "shatter not only our hard-earned health benefits, but destroy the foundation of the 40-hour workweek that is the backbone of the American middle class" (7/17). 

Milwaukee Journal Sentinel: Potholes Ahead For Obamacare
Any governor understands that to launch job growth, states have to have a strong foundation. It is not just easing the tax and regulatory burden that spells success. Without well-developed transportation infrastructure, growth is stifled. One cannot increase trade with crumbling roads and rails. Similarly, when suddenly increasing the traffic in health care by adding 34 million newly insured patients, one has to examine the infrastructure supporting the load (Tommy Thompson, 7/17).  

Fiscal Times: The Great Obamacare Workforce Exodus
Congress based the Affordable Care Act reform in 2010 on a model that made a couple of key assumptions about employment. The White House projected rosy growth that would lead to job creation; and this rapid expansion would take place prior to Obamacare’s implementation, reducing the temporary costs of safety-net programs, including Medicaid. The new employer mandate would then ensure that new and existing full-time workers would not require subsidies to purchase individual health-care plans in new state-based insurance exchanges, keeping costs and new tax revenue balanced to keep the ACA from becoming a deficit driver in its first decade. Neither of these assumptions has panned out (Edward Morrissey, 7/18).

Forbes: Will Medicare's 'Two Midnights' Rule Endanger Patients By Distracting Doctors?
A fundamental principle of the American health care system has always been that your medical care is driven by two things: your own choices and your doctor's judgment. It's what's right, and it's what works. But if a new rule proposed by the Centers for Medicare and Medicaid Services is finalized August 1, that principle will be undermined by removing provider judgment from the decision to admit a patient to the hospital. ... The new rule would be that if a patient is expected to spend at least two midnights in the hospital, the inpatient stay would be presumed to be medically necessary – and thus covered by Medicare (Dr. Kavita Patel and John Rother, 7/17).

The New York Times: A Second Chance For The World's Disabled
There was a painful moment on Capitol Hill in December when former Senator Bob Dole, seated in a wheelchair, was greeted warmly by old Republican colleagues but then rebuffed by some of those very same members after he had urged Senate ratification of a United Nations treaty defending the rights of people with disabilities. ... skittish Republicans bought into a nonsensical attack by right-wing critics that it would undermine national sovereignty. Senator Robert Menendez, a New Jersey Democrat and the chairman of the Senate Foreign Relations Committee, is now negotiating with the ranking committee Republican, Bob Corker of Tennessee, to arrange another vote (7/17). 

The New England Journal of Medicine: Communicating and Promoting Comparative-Effectiveness Research Findings
The comparative-effectiveness research (CER) movement has sparked an important debate about who may communicate research findings, for what purposes, and using what methodologic standards. CER is intended to inform discussions about what works in health care. Much of the information comes from research using retrospective databases and quasi-experimental designs rather than randomized clinical trials. ... Conceivably, the FDA will have to establish on a case-by-case basis whether any CER promotion, regardless of its intended audience, is "truthful." However, a great deal of uncertainty prevails, and it may be some time before there is clarity around the issue (Peter J. Neumann, 7/18).

The New England Journal of Medicine: Tobacco Use Among Homeless People — Addressing the Neglected Addiction
Although the prevalence of smoking in the United States has declined, vulnerable and marginalized groups continue to use tobacco at high rates. One such group is the 2.3 to 3.5 million people nation-wide who are homeless in any given year. Approximately three quarters of homeless adults are cigarette smokers ... Though the challenges of addressing tobacco use in this population are many, we believe that ignoring this issue is no longer justifiable — and that the conversation should shift away from the question of whether to address smoking among homeless people and toward the question of how (Drs. Travis P. Baggett, Matthew L. Tobey and Nancy A. Rigotti, 7/18). 

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