KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: June 12, 2014

Today's headlines include stories examining how Eric Cantor's primary defeat will change the House GOP leadership and the Republican strategy to replace the health law.   

Kaiser Health News: For Women Just Out Of Jail, Health Care Could Be Key To Better Life
Reporting for Kaiser Health News, in partnership with NPR, KQED’s April Dembosky writes: “The San Francisco Sheriff's Department is implementing a new city law allowing its staff to enroll inmates into health insurance under the Affordable Care Act. Sheriff Ross Mirkarimi believes that making sure people have health coverage when they're released will help prevent them from committing another crime and coming back. One inmate – Sophia – recently requested help signing up for health insurance. Sophia, who asked that her last name not be used, was caught driving a stolen car in January and sentenced to three months in the county jail. She says that was because she stopped getting treatment for her substance abuse and mental health problems when her health insurance expired” (Dembosky, 6/12). Read the story.

Kaiser Health News: Capsules: Obamacare Health Spending Surge? Not So Fast; Some Costly Hospital Complications Not Tracked by Medicare, Analysis Finds
Now on Kaiser Health News’ blog, Jay Hancock reports on developments related to health care spending estimates: “A growing economy and an Obamacare spending surge, many suspected, had ended five years of moderate health-spending growth. Early government figures showed medical-cost acceleration at the beginning of the year. … Not really. The preliminary estimates that prompted the story were off. Hospital revenue fell in 2014′s first quarter compared with the final three months of 2013, the Census Bureau estimated Wednesday. So did revenue for medical labs and outpatient care (Hancock, 6/12). 

Also on the blog, Jordan Rau reports on a new analysis regarding hospital complications: “Premier, Inc., a consulting company that works with hospitals on improving quality, analyzed 5.5 million patient records to identify 86 common ‘complications’ that occurred in the hospital and were associated with patient deaths, higher costs or longer lengths of stays. The consultants offered estimates for each condition, which include heart attacks in the hospital, sepsis and acute kidney failure” (Rau, 6/12). Check out what else is on the blog.

The Wall Street Journal: Mixed Bag For Health Co-Ops
Many of the nonprofit health-insurance cooperatives created by the Affordable Care Act have enrolled far fewer people than they had hoped, according to figures obtained by a Republican-led House committee, calling into question their viability. Fourteen of the 23 co-ops reported to the panel that, as of April 1 or later, they had enrolled significantly fewer people than they had projected for 2014 when they obtained $2 billion in federal loans from a fund created under the health law. The shortfalls create steeper obstacles for the plans to succeed and repay the loans (Radnofsky, 6/11).

The Associated Press: Insurers Propose Changes To Obama Health Law
Insurers want to change President Barack Obama’s health care law to provide financial assistance for people buying bare-bones coverage. That would entice the healthy and the young, the industry says, holding down premiums. So-called catastrophic plans are currently not eligible for the law’s subsidies, and only 2 percent of the 8 million consumers who signed up this year picked one. Subsidies bring down the cost of monthly premiums (6/11).

The Wall Street Journal: Eric Cantor To Step Down As House Majority Leader
On the policy front, the Cantor defeat squelches whatever slim chance remained for Congress to enact immigration reform later this year. The majority leader was also in the process of drafting a Republican alternative to the 2010 health law and building an agenda for the next Congress, when many expected him to assume the House speakership from John Boehner of Ohio (Peterson, O’Connor and Hook, 6/11).

Politico: No Eric Cantor, No Obamacare ‘Replace’ Vote
House Majority Leader Eric Cantor’s shocking primary loss Tuesday night all but kills any chance of the House voting on an Obamacare replacement bill this year. The prospects of Republicans rallying around a replacement policy and scheduling a vote was already an uphill endeavor — one that few expected to actually happen. After all, the House GOP had been trying to agree to a plan for several years already (Haberkorn, 6/11).

The Wall Street Journal: David Brat's Writings Give An Early Picture Of His Political Philosophy
He opposes government efforts to help the poor through unemployment and health insurance because it would, he warned, leave them entitled. He has said that a dictator like Hitler "could all happen again, quite easily" if Christian people don't strongly assert their faith (Epstein, 6/11).

The Washington Post: Va. Leaders May Vote On Stripped-Down Budget
House budget leaders on Wednesday unveiled a two-year, $96 billion spending plan that their Senate counterparts indicated they would be willing to accept and fast-track to Gov. Terry McAuliffe (D). But at least a few Republicans are expressing concern that the long-stalled budget process is suddenly moving too quickly. They fear that there could be language buried deep in the budget bill that would authorize the governor to expand Medicaid, McAuliffe’s top legislative priority (Vozzella, 6/11).

The Associated Press: Virginia Lawmakers Return To Vote On Budget
The budget stalemate was caused by a disagreement between Democrats, including Gov. Terry McAuliffe, who wanted to expand Medicaid and Republicans who refused. The logjam broke when Democratic Sen. Phil Puckett resigned, giving Republicans a one-seat advantage in the Senate (6/12).

The New York Times: Treasury Secretary Points To Lackluster Economy And A Need 
For Action
Fixing the immigration system, he argued, might have an enormous impact on economic output. “Immigration reform is good economic policy,” he said. “The nonpartisan Congressional Budget Office has estimated that the immigration reform bill, which passed the Senate on a bipartisan basis last year, would increase the labor force, boost G.D.P. by 3.43 percent over the next 10 years and improve our fiscal position by $158 billion, strengthening the Social Security and Medicare trust funds” (Lowrey, 6/11).

The Wall Street Journal: Senate Approves Bipartisan VA Overhaul Legislation
A Senate bill passed on Wednesday opens the door to widespread changes in the Department of Veterans Affairs health care system, including allowing more veterans to seek care from providers outside the VA and letting the department's secretary fire senior executives more easily. The bill—a bipartisan compromise struck by Sens. Bernie Sanders (I., Vt.) and John McCain (R., Ariz.)—was unveiled last week and in some respects resembles legislation passed Tuesday by the House (Kesling, 6/11).

The Associated Press: Senate Backs Bill To Improve Health Care For Vets
The Senate bill, approved 93-3, makes it easier for veterans who have encountered delays getting initial visits to receive VA-paid treatment from local doctors instead. The measure closely resembles a bill approved unanimously Tuesday in the House, prompting optimism among lawmakers from both parties that a compromise version could be on its way soon to President Barack Obama for his signature. The White House said Wednesday that Obama supports the Senate bill (6/11).

Los Angeles Times: Senate Oks VA Reform Bill As FBI Launches Criminal Investigation
The Senate on Wednesday broke through the usual partisan gridlock to swiftly approve legislation aimed at reducing veterans’ long waits for healthcare, as the FBI announced that it has launched a criminal probe in the Department of Veterans Affairs scandal. The bill would allow veterans facing long waits at VA facilities to seek care from private doctors, expand the VA secretary's authority to fire staff for poor performance, authorize the department to lease 26 new health facilities in 17 states, including California, and Puerto Rico. It also would provide $500 million for expedited hiring of new VA doctors and nurses (Simon, 6/11).

The Wall Street Journal: Senate Approves Bipartisan VA Overhaul Legislation
A major provision of the bill would allow, for the next two years, veterans to go to any hospital that participates in Medicare for appointments if they can't get an appointment within the VA's wait-time goals or live more than 40 miles from a VA facility. … The bill also would authorize the VA to lease 26 major medical facilities in 17 states and Puerto Rico. The VA's inspector general would be tasked to identify medical fields with the largest staffing gaps, and the department would be allowed to fill those positions quickly. In addition, the VA would publish appointment wait-time goals for every VA location—along with the actual wait times (Kesling, 6/11).

Politico: Senate Passes VA Reform Bill 
But if the Senate’s bill eventually comes law, there could be a large tab for Washington. The Congressional Budget Office estimated on Wednesday afternoon that increased veterans health-care access could cost the federal government an additional $50 billion a year (Everett, 6/11).

The Wall Street Journal: FBI Opens Criminal Probe Of VA’s Practices
The Federal Bureau of Investigation has opened a criminal probe into scheduling practices at the Department of Veterans Affairs, escalating the stakes in a scandal that has already led to the resignation of the agency's leader. Law-enforcement officials had previously acknowledged the Justice Department is reviewing documents provided by the VA inspector general to see if any potential crimes were committed in how the agency managed its appointment schedules. The opening of a criminal probe takes that work a step further and could lead to criminal charges if law enforcement finds evidence of fraud or misuse of government resources (Barrett, 6/11).

The New York Times: FBI Begins Criminal Inquiry In VA Scandal
The F.B.I. has opened a criminal investigation into accusations that Department of Veterans Affairs officials manipulated medical waiting lists and delayed care for thousands of veterans, the F.B.I. director, James B. Comey, said Wednesday (6/11).

Politico: FBI Opens Criminal Probe On VA Wait Lists
Attorney General Eric Holder had said previously that prosecutors were in regular contact with the Department of Veterans Affairs inspector general’s office, which conducted the initial probe into the allegations that VA employees doctored the waiting lists and kept multiple lists in order to make sure employees qualified for bonuses. However, in earlier comments, Holder did not announce a criminal investigation — a status which means evidence of illegality has crossed a particular threshold (Gerstein and Kopan, 6/11).

The Washington Post: Most Expensive For A Doc Visit? San Francisco. Least Costly Cholesterol Test? Pittsburgh
People who live in San Francisco pay the most, on average, for a doctor’s visit ($251), and folks in Miami pay the least ($95). Indianapolis is the most expensive for a cholesterol test ($89) and Pittsburgh is the least costly ($19). And Sacramento comes in highest for both CT scans of the head ($1,404) and MRIs of the lower back ($2,635). Those are the range of prices for four of the most common medical services in 30 of the most populous cities in the United States, according to an analysis by Castlight Health, a San Francisco-based company that works with employers on controlling health-care costs (Sun, 6/10).

The Wall Street Journal: Abortion-Bill Backers In Albany Split On Strategy
Abortion-rights supporters are divided over how to pass legislation in Albany, as Gov. Andrew Cuomo's Women's Equality Act remains opposed by state Senate Republicans over the abortion issue. One faction, led by Assemblywoman Amy Paulin, a Westchester Democrat, is pushing to break apart Mr. Cuomo's 10-part package of women's rights legislation and vote separately on the bills, saying it has no chance of passing the state Senate with the abortion provision. The package died in the Senate over abortion last year (Gay, 6/11). 

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