- Kaiser Health News Original Stories 6
- House Tax Bill Would Scrap Deduction For Medical Expenses
- House Republicans Aim To Yank Tax Credits For Orphan Drugs
- Big Premium Hike? Blame It On The Kids
- Facebook Live: It’s ACA Sign Up Season. Here’s What you Need To Know This Year.
- Podcast: 'What The Health?' How Confused Are We?
- New ‘Instructions’ Could Let Dementia Patients Refuse Spoon-Feeding
- Political Cartoon: 'Fire Sale?'
- Capitol Watch 3
- Republicans' Tax Plan A Mixed Bag For Health Care
- Logjam Over CHIP Funding A Testament To Level Of Partisan Rancor Gripping Congress
- Controversial Medicare Cost-Cutting Board Back In Congress' Crosshairs
- Public Health And Education 3
- Experts Agree Opioid Prescribing Patterns Are Moving In Right Direction, But Suggest More That Can Be Done
- Study Questioning Effectiveness Of Stents Easing Heart Pain Stuns, 'Humbles' Cardiologists
- Scientists Envision Creating Algorithm To Hunt Down Next Epidemic -- And Help Them Stop It
- State Watch 1
- State Highlights: Despite String Of Defeats, Texas Defends Another Anti-Abortion Measure; D.C. Public Hospital Failed To Report Key Details Of Patient's Death
- Health Policy Research 1
- Research Roundup: Pesticide's Effects On Reproduction; Readmissions Reduction
From Kaiser Health News - Latest Stories:
About 9 million people claimed about $87 billion in medical deductions in 2015. (Julie Rovner, 11/2)
House Republicans want to repeal federal tax credits that have helped spur a boom in orphan drugs for rare diseases. (Sarah Jane Tribble, 11/2)
Premiums are rising for many reasons next year, and one is that insurers are charging a lot more for teenagers. (Courtney Perkes, 11/3)
In this Facebook Live chat, KHN’s Julie Appleby answers questions about what's changed for 2018 open enrollment. (11/2)
In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Stephanie Armour of The Wall Street Journal, Joanne Kenen of Politico and Paige Winfield Cunningham of The Washington Post discuss the start of open enrollment under the Affordable Care Act, legislative efforts on Capitol Hill on taxes and children’s health insurance, and recommendations of the president’s opioid commission. (11/2)
Patients with Alzheimer’s disease and other dementias can say in advance if and when they want caregivers to stop offering food and fluids by hand. (JoNel Aleccia, 11/3)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Fire Sale?'" by John Deering, Arkansas Democrat-Gazette.
Here's today's health policy haiku:
INCREASED STANDARD DEDUCTION WON'T HEAL AMPUTATED MEDICAL DEDUCTION
"We promised voters!"
Be careful what you ask for.
DID we ask for this?
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
Planning for end-of-life medical care can be daunting and uncomfortable, which is why so many people put it off – or don’t do it at all. Join KHN on Wednesday Nov. 8 from 3 p.m. until 4:30 p.m. ET for a discussion about navigating end-of-life care. RSVP here.
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Summaries Of The News:
Media outlets examine how the health care landscape -- from med students to pharmaceutical companies -- would be touched by the Republicans' tax plan unveiled Thursday. A potential large impact to consumers would be the elimination of medical expense deductions. Another: the proposal does not include language to repeal the individual mandate despite President Donald Trump's support for the provision.
The Associated Press:
GOP Tax Plan May Offer Little Aid For Many In Middle Class
House Republicans have stressed that the tax plan they unveiled Thursday is tailored to benefit America's middle class. Just how much it would remains uncertain based on the details that have been provided so far. What is clear is that many of the benefits for the middle class could dwindle over time, even while companies and wealthy individuals could enjoy lasting tax advantages. (Boak, 11/2)
The New York Times:
Who Wins And Who Loses From The Republican Tax Plan
Under the Republican plan, the deduction for medical expenses would be eliminated. This currently applies to taxpayers, spouses or other dependents with health expenses that exceed a tenth of the taxpayer’s income. AARP, which advocates for retirees, said that they strongly opposed the repeal of the deduction and said that doing so would impose a “health tax” on the oldest and sickest Americans. (Rappeport, 11/2)
House GOP Tax Cut Bill Has Pluses And Pitfalls For Healthcare Stakeholders
Healthcare companies, executives and professionals could enjoy lower business and personal taxes while facing reduced revenue due to Medicare and Medicaid cuts that may be used to pay for the tax reductions, under the House Republican tax reform bill released Thursday. The 429-page Tax Cuts and Jobs Act—which congressional Republicans hope to pass quickly through the expedited budget reconciliation process with little or no Democratic support—would slash the corporate tax rate from 35% to 20%. That would benefit profitable companies like UnitedHealth Group, HCA and Universal Health Services, according to an analysis by Mizuho Securities. (Meyer, 11/2)
House Bill Affects Medical Expense, Drug Industry Tax Breaks
The House Republican tax proposal would repeal a tax credit meant to spur research spending on treatment for rare diseases. The tax bill (HR 1) as released Thursday, would repeal the orphan drug tax credit beginning in 2018. Drug manufacturers currently can claim a 50 percent tax credit on some costs of clinical research and testing of treatments for certain rare medical conditions under the 1983 Orphan Drug Act. (McIntire, 11/2)
Kaiser Health News:
House Tax Bill Would Scrap Deduction For Medical Expenses
The tax bill unveiled by Republicans in the House on Thursday would not, as had been rumored, eliminate the tax penalty for failure to have health insurance. But it would eliminate a decades-old deduction for people with very high medical costs. The controversial bill is an effort by Republicans to revamp the nation’s tax code and provide dramatic tax cuts for business and individuals. However, its future is not yet clear because Republicans, who control both the House and Senate, appear divided on key measures. (Rovner, 11/2)
Tax Bill's Plan To Kill Medical Expense Deduction Raises Political Stakes
House Republicans have proposed eliminating a medical expense tax deduction popular with Americans with high medical costs, one of several political landmines the GOP is touching in tax reform. The deduction is used by comparatively few tax filers, but its impact can be significant for Americans with large medical bills, including nursing home expenses, insurance premiums paid with after-tax dollars or other medical tabs. (Haberkorn and Wilhelm, 11/2)
GOP Tax Plan Would End Student Loan Deduction Used By Young Doctors
Newly minted doctors and other health care workers may lose a critical tax deduction under the tax code overhaul House Republican leaders unveiled Thursday. The proposal repeals the student loan interest deduction — a policy that helped more than 12 million Americans who racked up education loans save up to $2,500 on their tax bills in 2015. The popular policy doesn’t require taxpayers to itemize their deductions to claim it — instead, it’s available to anyone paying interest on either private or public student loans who makes less than $80,000 in a year. (Mershon, 11/2)
7 Ways Biopharma Would Win — And Lose — Under The New Tax Bill
Biopharma can find plenty to celebrate — and a few things to despair over — in the new Republican plan to rewrite the tax code. The long awaited “Tax Cuts and Jobs Act,” unveiled as a House bill on Thursday, will likely still be revised significantly. But so far, here are the seven provisions with the biggest implications for the drug industry. (Robbins, 11/2)
Kaiser Health News:
House Republicans Aim To Yank Tax Credits For Orphan Drugs
As part of a sweeping tax reform bill, House Republicans on Thursday proposed eliminating billions of dollars in corporate tax credits that have played a key role in the booming “orphan drug” industry. For more than three decades, pharmaceutical and biomedical companies have claimed a 50 percent tax credit for the cost of clinical trials on orphan drugs, or those that treat rare diseases affecting fewer than 200,000 people. (Tribble, 11/2)
Tax Bill Will Not Seek Repeal Of Individual Health Insurance Mandate
The tax reform bill to be released Thursday will not include a repeal of ObamaCare's individual mandate, sources say, despite President Trump proposing the idea on Wednesday. Repealing the mandate would introduce a whole new area of controversy into the bill, and many Republicans think tax reform is hard enough without adding in health care. (Sullivan, 11/2)
Trump Still Pushing For ObamaCare Mandate Repeal In Tax Bill
President Trump told House Republicans in a meeting Thursday that he still wants to repeal ObamaCare's individual mandate in tax reform, perhaps in the Senate, according to two lawmakers in attendance. "He just said he liked the idea and he had asked the senators about it and they said they were considering it," said Rep. Kristi Noem (R-S.D.), who was in attendance at the meeting of House leaders and Ways and Means Committee members with Trump at the White House. (Sullivan, 11/2)
The program to provide health care for kids from low- and middle-income families is extremely popular, but it's been stuck in limbo since its funding expired over a month ago. The House is expected to pass a bill Friday, but the Senate Democrats will almost certainly balk at how the lawmakers want to pay for the program.
The New York Times:
House To Vote On Child Health Care, But Funding Will Remain In Limbo
The House on Friday is expected to pass legislation to refinance the Children’s Health Insurance Program and send federal funds to community health centers. But a partisan morass over how to pay for the legislation all but ensures that state governments and millions of children will get little relief from the uncertainty that has faced the programs since funding officially expired a month ago. (Pear, 11/2)
House Begins Debate On Children's Health Bill
The House kicked off debate on a bill to renew funding for the Children’s Health Insurance Program and community health centers on Thursday after the Rules Committee advanced the bill late Wednesday. A vote on passage of the legislation is expected Friday. Energy and Commerce Committee Democrats have not thrown their support behind the bill (HR 3922), due to disagreements over the offsets, which would change Medicare, Medicaid and provisions of the 2010 health care law (PL 111-148, PL 111-152). Similarly, the Rules Committee vote on Wednesday fell on party lines with all present Democrats voting against proceeding with the bill. (Raman, 11/2)
Senate Dems Warn Against Cutting ObamaCare Fund To Pay For Children's Health Program
Senate Democrats warned Republican leadership Thursday against cutting ObamaCare's public health fund to pay for an extension of the popular Children's Health Insurance Program (CHIP). A bill the House is expected to pass this week to extend funding for CHIP would pay for it through cuts to ObamaCare's Prevention and Public Health Fund (PPHF). (Hellmann, 11/2)
Anxiety Grows Over Community Health Centers Funding Standoff
Many community health centers received an unnerving email from the federal government this week: It informed them that they should begin preparing for their federal grant to expire at the end of the year. The notifications received by clinics around the country Wednesday are the most tangible evidence yet of the congressional standoff over funding for community health centers, which have traditionally received bipartisan support. (Demko and Rayasam, 11/2)
The House voted to abolish the Independent Payment Advisory Board (IPAB), even though no one has even been appointed to the panel and it's not expected to be triggered until 2021 or 2022.
House Votes To Repeal ObamaCare's Medicare Cost-Cutting Board
The House on Thursday voted to repeal a controversial Medicare cost-cutting board that has drawn the ire of both parties. Lawmakers voted 307-111 to abolish what is known as the Independent Payment Advisory Board (IPAB). The board is tasked with coming up with Medicare cuts if spending rises above a certain threshold but has been criticized as outsourcing the work of Congress. (Weixel, 11/2)
House Passes Repeal Of Medicare Advisory Board
The Senate has no clear plans to take up a similar bill in the near future, and the bill may not win enough Democratic support to pass that chamber. The board, commonly referred to by its acronym, IPAB, was created under the 2010 health law (PL 111-148, PL 111-152), to identify ways to decrease federal spending on Medicare without affecting coverage or quality. The 15-member board hasn’t actually been formed, though, and isn’t expected to be triggered until 2021, according to a 2017 annual report from the Medicare Trustees. Tennessee Rep. Phil Roe, the lead Republican on the bill, said the types of decisions that IPAB would make when triggered should be made by elected officials. (McIntire, 11/2)
In other Medicare news —
CMS Allows More Docs To Sit Out MACRA
The CMS has finalized a proposed rule to exempt more small providers from complying with MACRA. It also reversed course on plans to give providers a pass on gauging whether they are cutting costs under the Merit-based Incentive Payment System, or MIPS. Physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year would be exempted under the rule finalized Tuesday. The move will exclude about 134,000 more providers. The original threshold for exemption is $30,000 in Medicare revenue or fewer than 100 Medicare patients. (Dickson, 11/2)
CMS Dials Back Plan To Slash Payment For Off-Campus Services By Half
The CMS has finalized its proposal to slash what Medicare pays for healthcare obtained at medical facilities that are owned by hospitals but located off their campuses. The agency released its finalized 2018 physician fee pay rule Thursday, dropping off-campus facilities' rates from 50% to 40% of what they would have been paid under outpatient rates. Originally, the CMS had proposed to drop the rate to 25%. The Obama administration last year finalized a rule that paid hospital off-campus facilities the same as hospital-based outpatient departments if they started billing Medicare after Nov. 2, 2015. (Dickson, 11/2)
The Trump administration has slashed marketing and outreach budgets, but these groups are doing what they can to help people enroll for coverage under the Affordable Care Act. Meanwhile, a new study is the latest to confirm that President Donald Trump's decision to end insurer subsidies will actually result in more people getting "free" health care on the exchanges, and health care providers worry the government's crackdown on immigration will hurt sign-ups.
The Associated Press:
Health Care Enrollment Counselors Facing Stiff Challenges
It's not easy being an advocate for the Affordable Care Act right now. Health care advocacy groups are making an against-all-odds effort to sign people up despite confusion and hostility fostered by Republicans opposed to President Barack Obama's signature domestic policy achievement. (Kennedy, 11/2)
The Associated Press:
Free ‘Obamacare’ For Older, Poorer In Nearly All Counties
Older people with low incomes nearly everywhere would have access to free “Obamacare” health coverage next year, according to a study Thursday that found the Trump administration’s efforts to undercut the Affordable Care Act have broad unintended consequences. The analysis by the consulting firm Avalere Health found that in nearly 98 percent of counties served by HealthCare.gov, a 50-year-old making about $18,000 a year would be able to get a basic “bronze” plan for no monthly premium in 2018. (Alonso-Zaldivar, 11/2)
How Trump’s Immigration Crackdown Threatens Obamacare
As Obamacare open enrollment begins, health-care providers in immigrant communities worry that the Trump administration’s hard line on immigration will spook some immigrants and their U.S.-born relatives away from seeking health insurance. ... About 17 percent of lawfully present immigrants under age 65 were uninsured in 2015, almost twice the rate of U.S. citizens, according to the Kaiser Family Foundation. (The rate was even higher, 41 percent, among the undocumented, who can’t get health coverage under the ACA or, in most states, Medicaid.) (Tozzi, 11/2)
In other health law news —
Big Premium Hike? Blame It On The Kids
Dede Kennedy-Simington, an insurance agent in Pasadena, Calif., was “totally dismayed” when she learned recently that the premium on her family’s Blue Shield PPO would rise $391 a month next year — driven largely by huge increases for her two teenage children. The cost of insuring her 16-year-old daughter will spike 60 percent in 2018, and it will jump 38 percent for her 13-year-old son. (Perkes, 11/3)
Kaiser Health News:
Facebook Live: It’s ACA Sign Up Season. Here’s What You Need To Know This Year.
The open enrollment season for health insurance under the Affordable Care Act began this week. And a lot has changed for consumers who buy their own individual coverage through the health law’s state and federal marketplaces. For example, the sign-up period is shorter than it has been in the past. (11/2)
Kaiser Health News:
Podcast: ‘What The Health?’ How Confused Are We?
Open enrollment started with more of a whimper than a bang Nov. 1, as the Trump administration continued to talk down the health law it is required to operate. Meanwhile, on Capitol Hill, lawmakers continue to struggle to reach agreement on legislation to renew funding for the Children’s Health Insurance Program, which expired Oct. 1. And President Donald Trump’s commission on the opioid epidemic released its final report and recommendations. (11/2)
The Baltimore Sun:
Obamacare Signups Rise On First Day Of Enrollment Period In Maryland
Enrollments in health insurance through the state’s health exchange was robust on the first day of open enrollment Wednesday, with more people signing up for insurance than last year, officials said Thursday. Advocates and others had expressed concern that consumers would be confused by political wrangling and policy changes to the Affordable Care Act from the administration of Pres. Donald Trump that led to last-minute rate increases and a severe decrease in marketing dollars for the program. (Cohn, 11/2)
Obamacare Open Enrollment Reveals Divide Between Rural And Urban Texas
Texas has two realities when it comes to Obamacare. It's home to urban counties with among the highest enrollment in the country, and to two of only four rural counties nationwide with not a single enrollee in the federal health insurance exchange. (Rayasam, 11/2)
For All Of KHN's Open Enrollment Coverage, Visit https://khn.org/enrollment
Politico hosted a small working group of experts on opioids to get their take on how the U.S. should tackle its opioid epidemic. But one of the takeaways is that people need more money to wage this war. Meanwhile, former Rep. Patrick Kennedy is calling for $100 billion over the next 10 years as the minimum of what's needed.
The Opioid Crisis: Crucial Next Steps
America’s opioid epidemic has not abated. More than 64,000 Americans died of drug overdoses last year — seven per hour, according to the White House. Most of those deaths were from prescription painkillers, heroin, fentanyl and related drugs. Though the illicit street drugs have added complicated and lethal dimensions to the public health crisis, the problem has its roots in legal painkillers — and pain itself. And while some parts of the country are hit harder than others, no place is immune. (11/1)
Patrick Kennedy: At Least $100 Billion Needed To Fight Opioids
Former Rep. Patrick Kennedy, a member of the president’s opioid commission, is calling for a robust infusion of federal funds to combat the opioid epidemic, to the tune of $100 billion over 10 years. In an interview with The Hill, Kennedy stressed he views that dollar figure “just as a starting point, at a minimum, minimum, minimum.” (Roubein, 11/2)
And in news from the states —
In Update To Lawmakers, Kansas AG Says Opioid Use Up While Meth Remains An Issue
Anecdotal evidence from prosecutors across the state indicates opioid abuse is growing in Kansas, Attorney General Derek Schmidt said, but he urged lawmakers not to forget the state’s ongoing methamphetamine problem. Schmidt answered questions about the issue Thursday from a panel of lawmakers in Topeka. Citing anecdotes from county attorneys and statewide health department data on drug poisonings, Schmidt said he believes Kansas has so far been spared the full extent of the opioid crisis that states farther east are reporting. But he told lawmakers they shouldn’t count on things staying that way. (Llopis-Jepsen, 11/2)
The Associated Press:
New Mexico Looks For Opioid Solutions Amid Tributes To Dead
A Day of the Dead altar with family photos of orphaned children in the arms of the departed stood as silent testimony to New Mexico's struggle to reduce the toll of opioid addiction, while state lawmakers and health care experts searched Thursday for new tools to combat deaths from the drug crisis gripping the nation. The unique display at a summit attended by some 300 people in the most Hispanic state comes amid Dia de Los Muertos, a Mexican holiday remembering loved ones who have died. (11/2)
Researchers found that the devices are mostly useless for hundreds of thousands of patients.
The New York Times:
‘Unbelievable’: Heart Stents Fail To Ease Chest Pain
A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them, researchers reported on Wednesday. Their study focused on the insertion of stents, tiny wire cages, to open blocked arteries. The devices are lifesaving when used to open arteries in patients in the throes of a heart attack. (Kolata, 11/2)
The Wall Street Journal:
Study Raises Questions About Stents In Some Heart Patients
The 200-patient study conducted by U.K. researchers found that patients with stable chest pain, or angina, who received stent devices experienced no significant improvement in exercise time on a treadmill, compared with similar patients who received no stents during sham procedures. All patients had received intensive treatment with heart drugs for six weeks before the real or fake procedures. (Loftus, 11/2)
The Star Tribune:
Heart Stents Fail To Ease Chest Pain, Landmark Study Says
A study of 200 heart patients in the United Kingdom shocked the international cardiology community on Thursday when it reported that patients who had stents put in to treat nonemergency chest pain showed about the same improvements as patients who got a “sham” placebo procedure. The findings from the first-of-its-kind study contradicted widespread assumptions that using the metal mesh tubes to prop open clogged arteries would allow patients to walk longer on a treadmill by hastening blood flow to the muscles that make the heart pump. (Carlson and Olson, 11/2)
“One day, I hope that biologists will forecast disease outbreaks in the same way meteorologists forecast the weather," disease ecologist Barbara Han says. "With one major difference: A meteorologist can’t stop a storm front, but we may be able to prevent outbreaks.” In other public health news: an app to monitor children's developmental milestones; statistics on rape; an Alzheimer's trial; skin creams; and nicotine.
Milwaukee Journal Sentinel:
Outbreak: Can Math Be Used To Predict An Outbreak?
Biologists are now monitoring possible outbreak signs, for example, weather patterns that could boost mosquito numbers in certain regions; or land-use changes that bring us into closer contact with animals carrying diseases capable of jumping to humans. ...Driving this effort to translate early signals in nature into accurate disease warnings are the powerful, problem-solving operations called algorithms, building blocks of the computer age. (Johnson and Oxenden, 11/2)
CDC App Tells Parents When To Be Concerned About Child’s Development
The CDC last week released a free tool for parents who want to monitor their children’s developmental accomplishments — and learn more about where they may be falling behind. The app, called Milestone Tracker, is available for iPhone and Android. It allows parents to create a personalized checklist for the emotional and physical developmental milestones of children aged 2 months to 5 years. (Scott, 11/2)
Here Are Three Startling New Stats On Rape
According to a new data analysis from researchers at the University of Michigan, by the time American women are in their mid-40s, a quarter of them will have been raped at some point in their lives. ...It relies on a federal survey conducted by the U.S. Centers for Disease Control and Prevention known as the National Survey of Family Growth. (Yeung, 11/2)
Kansas City Star:
Alzheimer's Prevention Drug Trial Coming To Kansas City Suburb
The University of Kansas Alzheimer’s Disease Center in Fairway is one of 180 sites in more than 20 countries chosen to participate in the trial, which is being run by the Phoenix-based Banner Alzheimer’s Institute, the Swiss pharmaceutical giant Novartis and a California-based biotechnology company called Amgen. (Marso, 11/2)
Imported Skin Creams Can Pose Unexpected Health Risks
A dermatologist in Washington, D.C., was surprised to discover that one of her patients was using a powerful steroid cream bought without a prescription to treat a rash. It turns out that the patient and the patient's family, who are from Africa, bought the cream, called Funbact-A, at a local store focused on African goods. It contained betamethasone, a high-strength steroid sold only by prescription in the U.S. Though high-dose steroids are often used to treat skin conditions, they can cause problems including skin atrophy, acne, severe rashes, infections and systemic reactions. (Jochem, 11/2)
The Wall Street Journal:
Altria, Anticipating FDA Rule, Is Developing Reduced-Nicotine Cigarettes
Marlboro maker Altria Group Inc. said it has developed ways of producing reduced-nicotine cigarettes and aspires to become the U.S. market leader in noncombustible tobacco products such as e-cigarettes, ahead of potential federal requirements for tobacco companies to change their products. (Maloney, 11/2)
Media outlets report on news from Texas, D.C., Florida, Virginia, Maryland, Georgia, Kansas, Utah and California.
The Associated Press:
Texas Again Defends New Anti-Abortion Measures In Court
Texas defended new anti-abortion measures again Thursday in court following a string of defeats over efforts to change the disposal of fetal remains, deny Medicaid dollars to Planned Parenthood and outlaw a commonly used abortion method. The latest trial centers only on a new law Republican Gov. Greg Abbott signed in June that bans a second-trimester abortion procedure known as dilation and evacuation. Federal courts in at least four other states have blocked similar measures. (Weber, 11/2)
Testimony Begins In Challenge To Texas Abortion Law
A Texas law banning second-trimester abortions on living fetuses requires doctors to use untested, complicated and riskier procedures that have no medical benefit to the woman, an Oregon doctor who teaches and performs abortion testified Thursday. Kicking off a five-day federal court trial on a bid by abortion providers to overturn the law, Dr. Mark Nichols said the regulation would force physicians to choose from several methods of inducing “fetal demise” that carry increased risks of infection and injury before beginning the safest and most common type of procedure – dilation and evacuation, or D&E, beginning in the 15th week of pregnancy. (Lindell, 11/2)
The Washington Post:
The District's Troubled Public Hospital Did Not Disclose Key Details To Regulators After A 47-Year-Old Patient Died There In August
Officials at the District’s only public hospital failed to report to regulators key details about the death of a patient in the facility’s nursing home in August, an incident report submitted to the D.C. Department of Health shows. The report, obtained by The Washington Post through a public records request, left out information about the case of 47-year-old Warren Webb that would likely have triggered an investigation of the long-term care unit at beleaguered United Medical Center in Southeast Washington. (Jamison, 11/2)
Pulse-Inspired Orlando United Assistance Center Extends Counseling Help For Community
he Orlando United Assistance Center, created to help survivors of the Pulse massacre and families of the dead, is now offering free counseling to anyone affected by the tragedy — even those who weren’t in the club and didn’t lose a family member there.The service is expected to continue until at least 2020. (Santich, 11/2)
Residents Sue Chemical Maker Over Fires During Hurricane Harvey
Shannan Wheeler was born and raised in Baytown, Texas, an industrial suburb east of Houston that is part of the so-called chemical coast. Houses are tucked between chemical storage tanks. Parks back up to refinery smokestacks. (Hersher, 11/2)
Employer-Sponsored Health Insurance Market Holds Steady; Virginia Employees Average Cost Increased 5.1 Percent
The average total health benefit cost per employee in the U.S. rose 2.6 percent in 2017, according to the Mercer National Survey of Employer-Sponsored Health Plans. Over the past five years, that growth has averaged just 3.3 percent annually. (O'Connor, 11/2)
The Baltimore Sun:
As Howard County Population Continues To Grow, Hospital Plans For The Future
County officials have been consumed in recent months by concerns over how public infrastructures like roads and schools can keep pace with population growth, leaving some residents and officials to ask: what about the hospital? Between 2010 and 2035, the county’s population is expected to grow by 14 percent, according to state data. With that, Howard County is set to have one of the state’s largest increases of residents over 60 years old between 2015 and 2040. (Magil, 11/3)
Georgia Health News:
State’s Top Court Rejects Northside’s Stand On Shielding Financial Records
In a case closely watched by the state’s hospital industry, the Georgia Supreme Court has reversed lower court rulings that barred access to Northside Hospital’s financial records. The unanimous decision, announced Thursday, remands the case back to the trial court. Justice Nels Peterson wrote that the trial court applied the wrong legal standard in ruling against access to the records by plaintiff E. Kendrick Smith, an attorney. (Miller, 11/2)
Kansas City Star:
KU Hospital, Shawnee Mission Health And North Kansas City Join Accountable Care Organization
About 1,600 physicians from those three health systems and the independent Kansas City Metropolitan Physician Association announced this week they have formed a clinical integration network called Centrus Health Kansas City. They also announced that the network has an agreement with Blue Cross and Blue Shield of Kansas City, and has applied for one with Medicare, to form Accountable Care Organizations that tie payments to patient outcomes. (Marso, 11/2)
The New York Times:
Arrested Nurse Settles With Salt Lake City And University For $500,000
A Utah nurse who was forcefully detained by a police officer in July settled with the University of Utah and Salt Lake City on Tuesday for a total of $500,000. The rough arrest of the nurse, who had refused the officer’s request to draw a sedated patient’s blood as part of a police investigation, was captured on body camera video and viewed widely online. (Stevens, 11/2)
Los Angeles Times:
Glendale Health Festival To Provide Free Health Screenings
The eighth annual Glendale Health Festival will be held from 10 a.m. to 3 p.m. on Saturday at the Pacific Edison Community Center, 501 S. Pacific Ave., Glendale. The event will be free and open to the public. (Kellam, 11/2)
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Pesticide Residue Intake And Assisted Reproductive Technology Outcomes
In a cohort of 325 women undergoing infertility treatment with assisted reproductive technology, intake of high–pesticide residue fruits and vegetables was associated with a lower probability of live birth, while low–pesticide residue fruit and vegetable intake was not associated with this outcome. Dietary pesticide exposure within the range of typical human exposure may be associated with adverse reproductive consequences. (Chiu, Williams, Gillman et. al., 10/30)
How Have Providers Responded To The Increased Demand For Health Care Under The Affordable Care Act?
With 20 million more people insured today under the Affordable Care Act, health care providers have had to adapt to the increased demand for health care services. ...The number of urgent care and retails clinics grew, but telemedicine did not expand substantially. Behavioral health services remained the most significant unmet need. (Wishner and Burton, 11/2)
New England Journal of Medicine:
Effect Of A Hospital-Wide Measure On The Readmissions Reduction Program
The Hospital Readmissions Reduction Program penalizes hospitals that have high 30-day readmission rates across specific conditions. ...A transition to a hospital-wide readmission measure would only modestly increase the number of hospitals eligible for penalties and would substantially increase the penalties for safety-net hospitals. (Zuckerman, Joynt Maddox, Sheingold, et.al., 10/19)
Prevalence, Treatment, And Unmet Treatment Needs Of US Adults With Mental Health And Substance Use Disorders
We examined prevalence, treatment patterns, trends, and correlates of mental health and substance use treatments among adults with co-occurring disorders. Our data were from the 325,800 adults who participated in the National Survey on Drug Use and Health in the period 2008–14. ...Rates of receiving care only for mental health, receiving treatment only for substance use, and receiving both types of care among adults with co-occurring disorders remained unchanged during the study period. (Han, Compton, Blanco et. al., 10/1)
Opinion writers weigh in on the open enrollment period that started this week.
Donald Trump Wants To Sabotage Health Law. Here’s How To Sabotage Him.
The Trump administration has not only lopped the enrollment period in half, from 90 days to 45, but has also dramatically reduced advertising and outreach efforts. ...The intent there is obvious: Limit knowledge about the enrollment in the hopes of dampening sign-ups. ... As noted by Larry Levitt, senior vice president at the Kaiser Family Foundation, the results of this enrollment period will influence the debate over the laws future. So those who support the Affordable Care Act should do everything they can to spread the word and help make this enrollment effort a success. (11/3)
Los Angeles Times:
Researchers Suggest Delusion May Be At The Heart Of Conservative Hatred Of Obamacare
This week’s open enrollment for Obamacare once again made me wonder: How can conservatives be so convinced of the healthcare law’s failure when the opposite is demonstrably clear? Obamacare is far from perfect, but it’s in no way a “disaster,” a “catastrophe” or “imploding.” ... A paper in the latest issue of the Journal of Consumer Research, published by Oxford University Press, sheds light on their thinking by observing that conservative consumers are prone to “right-wing authoritarianism” and “system justification motivation.” Those are fancy ways of saying conservatives are more willing than liberals to accept what their leaders say as true and have little appetite for rocking the boat. (David Lazarus, 11/3)
Here’s Where To Get Help Choosing Obamacare Plans
If you buy health insurance on your own, rather than through an employer, picking a policy for 2018 is going to be more complicated than usual. Prices are going up for some people, coming down for others. Many areas have lost plans; some have gained new ones. And you don’t have a lot of time to sort out your options. This year’s open enrollment period is shorter than in the past. In most states it will end on Dec. 15, after just six weeks. ... Here are some of the resources and people you can consult. (Jonathan Cohn, 11/2)
Louisville (Ky.) Courier-Journal:
Health Insurance Is Still Available Under The ACA, But You Need To Act Quickly
With all the confusion about the status of the Affordable Care Act, the Louisville Metro Board of Health would like to echo Mayor Greg Fischer’s simple reminder during a press conference this week: The ACA is still the law, and insurance in the individual marketplace under the ACA is still available. But you need to act quickly! The signup period this year began Nov. 1 and ends Dec. 15 — that’s less than half the length it was in prior years. (Louisville Metro Board of Health, 11/2)
Nation Needs A Nonprofit Healthcare Model, Too
Today, healthcare costs are 18 percent of the GDP, and on a per-capita basis adjusted for currency, the United States is twice as expensive as most other First World countries, while medical outcomes place about 30th overall. Since the private-insurance model will be a significant part of our system, it is imperative that we return to the old, well-thought-out solutions to the insurance problems. We must have a competing nonprofit model — a public option. We must develop rules and regulations that ensure that insurance companies compete fairly, and manage cost and quality successfully inside their revenue stream, and not just selectively insure people whose cost will be lower than their premiums. (Charles C. Wilhelm, 11/2)
A selection of opinions on health care from around the country.
Community Health Centers, America's Largest Primary-Care Network, Are In Jeopardy
The Community Health Centers Fund expired Oct. 1. It accounts for 70% of all federal grants for community health centers. As America's largest primary-care network, CHCs are crucial for many of America's most medically underserved children and families, especially those living in rural areas. Unless Congress acts, these drastic cuts will negatively affect millions of children in every corner of the country. (Dennis Walto, 11/2)
Gov. Ducey Won’t Let Poor Kids Die…For Now (Though Congress Might)
Good for Gov. Doug Ducey. Congress can’t bring itself to fund the Children’s Health Insurance Program, which in Arizona is called KidsCare, so Ducey has announced a plan to keep the program going should the feds not act by December. The plan covers 23,000 underprivileged Arizona kids. (EJ Montini, 11/2)
Va. Case Shows Desperate Need To Put The Mentally Ill In Treatment, Not Prison
Christopher Sharikas is serving two life sentences in a Virginia prison, plus 30 years, for a crime that carried a seven- to 11-year recommended term. He was 16 years old when he was arrested for stealing a car and assaulting its owner. He has spent 20 years behind bars. Arguably, his 1997 crime is not why he remains imprisoned. Sharikas suffers from severe mental illness. Our society has relinquished control of him to our criminal justice system. And our mental health system is so broken that it failed to help him when it should have. (Pete Earley, 11/2)
The Washington Post:
I Thought We Had Years To Save My Sister From Addiction. It Was Already Too Late.
Within an hour of landing at the Buffalo airport in July, I am helping my little sister get to the bathroom at Kenmore Mercy Hospital after she’s been revived with Narcan. I don’t know it yet, but Jenny will die in six days. She’s just turned 44. ... Since then, every day I’ve tried to understand how my sister, who lived a middle-class suburban life with her two children, died of cirrhosis of the liver from opioid addiction and alcoholism without my family ever having an honest conversation about it. She didn’t do a single stint in rehab or have any interventions. She really never had a chance, because I didn’t have the courage to face the truth. (Kelly O'Connor, 11/2)
The Washington Post:
The Trump Administration’s War On Marijuana Will Make The Opioid Crisis Worse
The White House commission on addiction and opioids, led by New Jersey Gov. Chris Christie, released its final report Wednesday, listing 56 recommendations for addressing the country’s overdose epidemic. There are many solid recommendations in the report, such as training doctors to better prescribe these painkillers and mandating that health-care providers check drug-monitoring data before prescribing opioids to patients to make sure the patients aren’t “doctor shopping.” (Robert Gebelhoff, 11/2)
Louisville (Ky.) Courier Journal:
Helping Those Struggling With Addiction
The pain of the opioid epidemic continues to ravage communities across the country – especially here in Kentucky. For years, I have worked with my colleagues in Congress to fight back. Just recently, President Donald Trump took a significant step by formally recognizing a public health emergency for opioids. I commend the President for reaffirming his commitment to tackling this critical problem, and I am proud to stand with him as we continue combatting this heartbreaking issue. (Sen. Mitch McConnell, 11/2)
I Gave My Patients Flu Vaccines. You Won't Believe What Didn't Happen Next!
If you get the flu vaccine, you are between 50 and 70 percent less likely to get the flu, depending on how well the vaccine matches the current strains of the virus. You are slightly more likely to have soreness or a short fever with the flu shot, but you cannot get the flu from the shot, because it does not contain any live virus. (Elisabeth Poorman, 11/2)
Billings (Mont.) Gazette:
Eliminating Big Sky Rx Is Bad Medicine
With a looming budget crisis, state leaders are proposing deep budget cuts, which could result in a significant loss of funding for senior services. Not only are programs like hospice and home care services in jeopardy, but Big Sky Rx is on the chopping block as well. ... Big Sky Rx was created with the passage of Initiative 149 in 2004 when voters overwhelmingly approved an increase in tobacco taxes to pay for prescription drug assistance. The measure passed by a 2-to-1 margin. Bringing legislators from both sides of the aisle together with the business community, this landmark health care legislation was an initiative of a broad coalition of nonprofits and health care organizations. (Claudia Clifford, 11/2)