KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Obama’s ‘Olive Branch’ On Birth Control Coverage; Sen. Kirk Recounts His Stroke Therapy; Nurses Oppose Mandatory Flu Shots

Los Angeles Times: A Better Approach To Religious Employers And Contraception
The Obama administration released the final details Friday of the exemption it will provide religious-affiliated employers from the requirement to include free birth control in employees' insurance policies. Not surprisingly, the announcement didn't seem to mollify any of the critics who'd been arguing that the exemption was inadequate. That's true in part because the critics don't believe the exemption will function the way the administration has said it will. I think they're wrong, but I also think the administration should have taken a much different tack to resolve the dispute (Jon Healey, 2/1).

The Washington Post: From Obama, An Olive Branch To The Catholic Church On Contraception Coverage
The decision, the administration's second attempt at compromise, ought to be taken by the nation's Catholic bishops as the victory it is. Many of the country's most prominent prelates are inclined to do just that — even if the most conservative bishops seem to want to keep the battle raging. But more importantly, the final HHS rules are the product of a genuine and heartfelt struggle over the meaning of religious liberty in a pluralistic society. The contraception dispute was difficult because legitimate claims and interests were in conflict (E.J. Dionne Jr., 2/1).

The New York Times: A Good Compromise On Contraception
The Obama administration has proposed a sensible way to provide women who work for religiously affiliated institutions with free coverage of contraceptives while exempting the organizations they work for from financial or administrative obligations to provide the coverage. For the past year, the administration has been battered by lawsuits and denunciations from religious conservatives that its health care reforms violate religious liberties by requiring employers to provide free birth control coverage even if the employers have moral objections. Those attacks were designed to try to discredit the health care reform law and hurt President Obama politically by portraying him, falsely, as an opponent of religious freedom (2/1).

Los Angeles Times: In The Dark On Doctor Perks
Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient's condition. The doctor's motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor's participation in an experiment might compromise his medical advice (2/1). 

The Washington Post: Sen. Mark Kirk On How His Stroke Made Him A Better Senator -- And A Better Man
I wanted to give up almost every day. I was indescribably fatigued. I wanted to sleep all the time, a common desire in stroke sufferers. But I was beginning to believe. I used the prospect of returning to work, of climbing up the steps of the Capitol and walking the 50 paces to the Senate floor, as motivation. With every swing of my leg on the treadmill, I became more convinced I would do it (Sen. Mark Kirk, R-Ill, 2/2).

The Washington Post: The Risk Of Skimping On Mental Health Funding
A 14-year-old with large brown eyes and tightly cropped hair told me a few weeks ago that voices were telling him to kill people. A day before the Sandy Hook school massacre, he threatened to light his house on fire and stab everyone in the family, according to his mother. ... I am an outpatient therapist, working primarily with children and adolescents from disadvantaged backgrounds. Trevor is on Medicaid, yet cuts to Medicaid funding in recent years, here in North Carolina and throughout the country, mean that children like him slip through the cracks (Alyx Beckwith, 2/1).

The New York Times: We Can Be Healthy And Rich
Just about everyone agrees that health care in America is too expensive, and that something must be done to control the rising costs. Except for one group: hospitals and the unions representing hospital workers. ... But the truth is that bending the health care cost curve will actually spur the economy forward (Ezekiel J. Emanuel, 2/2).

Los Angeles Times: U.S. Debt Woes Are Not So Dire, Experts Say
Moreover, financial experts agree that although America's burgeoning health care costs pose huge long-term challenges for the budget, the nation's debt could most likely be controlled for at least the next decade by making a series of relatively moderate policy changes. Those changes, although perhaps unwelcome, would not require drastic adjustments in the lives of most Americans. ... Even if the bulk of the additional deficit savings needed came from reduced spending as opposed to higher taxes, (Moody's Analytics economist Mark Zandi) said, those cuts could be done by "tweaking programs," such as changing the inflation index for
Social Security, aligning Medicare drug payments with Medicaid and reducing some farm subsidies. "It wouldn't be a wrenching restructuring," he said (Don Lee and Jim Puzzanghera, 1/31).

The Texas Tribune/The New York Times: Plenty Of Money In State Coffers, But Not To Spend
Two years ago, Texas lawmakers didn't have enough money to spend. Now, it seems, they can't spend all the money they have. ... Last time, the solution was to play some accounting tricks and ignore certain expenses. ... Legislators decided to delete five months of Medicaid expenses from the back of the budget in the hope that the money to cover those costs would arrive before the bills did. Two years later, the comptroller said the state had $8.8 billion left, unspent, in its current accounts. Lawmakers will need most of it to fill that Medicaid hole and for other expenses that have surfaced since the budget was written (Ross Ramsey, 2/2).

The New York Times: Health Care's Trick Coin
This month, Johnson & Johnson is facing more than 10,000 lawsuits over an artificial hip that has been recalled because of a 40 percent failure rate within five years. Mistakes happen in medicine, but internal documents showed that executives had known of flaws with the device for some time, but had failed to make them public. It would be nice to imagine that this kind of behavior is exceptional, but in reality, the entire evidence base for medicine has been undermined by a casual lack of transparency (Ben Goldacre, 2/1).

The New York Times: Weighing The End Of Life
To many people's surprise, most of my patients are as satisfied with their lives as they were when they were less debilitated. But this isn't true for everyone, and some are eager to say they've had enough. They are bedbound or dependent, unable to do any of the things they once valued so dearly — working, caring for their families, eating solid food or even hearing the conversation of those who come to see them. Still others cannot express their wishes or needs but sit propped in chairs frowning and grimacing, despite attentive care and trials of antidepressants and pain medications (Louise Aronson, 2/2).

The New York Times: A Cruel Blow To American Families
The Internal Revenue Service has issued a hugely disappointing ruling on how to calculate the affordability of health insurance offered by employers. Its needlessly strict interpretation of the Affordable Care Act could leave millions of Americans with modest incomes unable to afford family coverage under their employers’ health insurance but ineligible for subsidies to buy coverage elsewhere (2/2).

USA Today: Flu Vaccine Mandate Protects Patients' Rights: Our View
Because so many of the most susceptible people are in hospitals and long-term care facilities, it's imperative that health care workers not spread the infection. In too many places, however, too many workers are balking at flu shot requirements, with potentially tragic consequences (2/3). 

USA Today: Forced Flu Shots Provide No Cure: Opposing View
America's nurses strongly encourage health care workers and patients to get vaccinated. But nurses, joined by many physician organizations and researchers, reject the notion that vaccination is a fail-safe solution to prevent the spread of the flu virus. We oppose forced vaccinations or the related mandate that those who decline the shots must wear masks or risk losing their jobs (Karen Higgins, 2/3). 

San Francisco Chronicle: Health Care Premiums Sometimes Taxed
Readers brought up some good comments about my Thursday column on the provision in the Affordable Care Act that requires most employers to begin reporting the cost of employer-provided health care on their W-2 forms, starting with W-2 forms issued for 2012. The cost, reported in Box 12 with the code DD, includes both the employer and employee share of health insurance premiums for the year. It might or might not include dental and vision care premiums depending on how the employer packages benefits. Some employers were exempt from the requirement for 2012 W-2s including those who filed fewer than 250 W-2s in 2011 (Kathleen Pender, 2/1).

Des Moines Register: Changes To Part D Won't Save Medicare
With a debt-ceiling showdown just around the corner, Republican lawmakers are insisting upon more government spending cuts in exchange for raising the country’s borrowing limit.
President Obama says the debt ceiling shouldn’t be used as a negotiating tool. But it’s inevitable that additional cuts will be seriously considered. And, unfortunately, lawmakers are likely to take aim at Medicare Part D, the highly successful prescription drug benefit. This approach is misguided. Cuts to Medicare Part D would have devastating consequences for seniors and taxpayers (Peter Pitts, 2/3).

Sacramento Bee: California Under The Microscope On Health Reform
The November election ensured that the most ambitious health care reform since the creation of Medicare in 1965 will take full effect come January 2014. California, like other states, is gearing up to ensure that affordable insurance is available when the individual mandate kicks in next January, requiring Americans to maintain health insurance coverage so they don't pass their costs to others. We already are far ahead of most states in setting up a marketplace – an "exchange" called "Covered California" – where people will be able to buy health insurance if their employer doesn't provide coverage (2/3).

San Francisco Chronicle: California Must Expand Medi-Cal
The Legislature is in a special session on health care to consider legislation that's designed to help California prepare for full implementation of the federal Affordable Care Act. Most Americans will have to buy health insurance in January 2014, or pay a penalty for not doing so. There are exceptions to this rule, of course, and one of the most important things that the Legislature is working on is the question of how to help the lowest income Californians get coverage. Assembly Speaker John Pérez, D-Los Angeles, has introduced AB1X1, which would greatly expand Medi-Cal, the state's health insurance program for the poor (2/1).

Kansas City Star: Medicaid Expansion In Missouri Would Help Patients And Hospitals
In return for financing the Medicaid expansion, Washington is going to phase out its “disproportionate share” payments to hospitals. That’s money it channels to hospitals to help cover losses incurred from treating uninsured patients. And this money is going away, whether a state like Missouri does or does not raise its Medicaid limits. Democratic Gov. Jay Nixon is pushing for the expansion, as are Missouri’s leading business and health care groups. Their hurdle is convincing Republican lawmakers who control the General Assembly, and who almost uniformly abhor "Obamacare"(2/1).

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