Administration Unveils New Round Of Health Law Rule Changes

Among the wide-ranging set of changes, the one drawing the most attention is the Obama administration’s decision to allow some consumers to keep health coverage into 2017 that does not comply with the overhaul’s minimum standards. Other changes include an extension of next year’s enrollment period, more backup for plans in insurance exchanges dealing with high patient costs and more time for states deciding whether to run their own marketplaces.

The New York Times: Some Policies Get More Time In Health Shift
The Obama administration, grappling with continued political fallout over its health care law, said Wednesday that it would allow consumers to renew health insurance policies that did not comply with the new law for two more years, pushing the issue well beyond this fall’s midterm elections (Pear,3/5).

Los Angeles Times: Consumers Allowed To Keep Substandard Health Plans Into 2017
The Obama administration announced Wednesday that some Americans with health insurance policies that don’t meet consumer standards set by the president’s new healthcare law would be allowed to keep their plans into 2017, three years later than originally envisioned. The delay, which could put off the final cancellation of some health plans until after President Obama leaves office, may have limited practical impact (Levey, 3/5).

The Washington Post: Obama Administration Rewrites Some Health-Care Policies
The Obama administration announced Wednesday that it has rewritten an array of far-reaching rules under the Affordable Care Act. … The rule changes will touch essentially every sector affected by the 2010 health-care law. It will buffer more health plans in insurance exchanges from high patient costs, give states more time to decide whether to run their own marketplaces, and spare certain unions from a fee they have resented (Goldstein and Somashekhar, 3/5).

The Wall Street Journal: Obama Gives Health Plans Added Two-Year Reprieve
But a series of delays by the administration—and decisions by states on implementing the law—have taken a toll. The latest delay came Wednesday, when federal officials said insurance companies could continue selling plans that don’t meet the law’s more rigorous standards until 2016 in some instances. It was the second time the administration delayed that requirement after the law’s tougher standards prompted insurers to cancel millions of people’s health plans last year. The latest delay averts another raft of cancellations before this year’s midterm elections (Radnofsky, 3/5).

The Associated Press/Washington Post: 2-Year Extension Offered For Canceled Health Plans
The decision helps defuse a political problem for Democrats in tough re-election battles this fall, especially for senators who in 2010 stood with President Barack Obama and voted to pass his health overhaul (3/5).

Kaiser Health News: Changes To Health Law Rules Include Extra Month To Enroll In 2015
The Obama administration on Wednesday released a broad set of regulatory changes to the health law that would give some consumers additional time to stay in plans that do not comply with all its coverage requirements and all consumers more time to enroll in coverage come 2015 (Carey, 3/6).

Reuters: U.S. Health Plans That Don’t Meet Obamacare Rules Can Renew For Two More Years
The Obama administration on Wednesday said it would allow health insurers to extend plans that fail to comply with its signature health law for an additional two years, a move Republicans quickly condemned as a politically motivated delay (Morgan, 3/5).

Bloomberg: Obamacare Policies Change for 2015 To Add Flexibility 
With midterm congressional elections bearing down, the government changed its regulation of Obamacare to give consumers and states more flexibility to decide on their health plans, insurers more time to sign up customers and taxpayers a chance to avoid more costs (Wayne, 3/5).

McClatchy: Canceled Health Insurance Plans Extended – Again
The administration’s second canceled-policy “fix,” following a one-year extension granted in November, was the most notable and controversial of several new executive branch tweaks made to the health law for next year. Theoretically, the move allows about 500,000 individual and 1 million small group health policies to continue through October 2017 (Pugh, 3/5).

ABC News: White House Extends ‘Keep Your Plan’ Fix for Obamacare
Facing growing opposition from his own party, President Obama announced a transition plan last fall that allowed Americans who were losing their coverage because it didn’t comply with the requirements of the Affordable Care Act to keep their plans for up to a year before being forced into coverage that meets the new standards. Today, the administration said it would extend that transition plan for two years to policies issued up to October 1, 2016, allowing consumers to renew their 2013 plans for two more years (Bruce and Good, 3/5).

NBC News: Feds Offer Two-Year Obamacare Delay For Some
Senior administration officials confirmed rumors that had been circulating for days that the administration would further extend the exception for people who object to being forced to buy new policies that meet tough new government requirements (Fox, 3/6).

CBS News: Obamacare Officials: No Concern About Mass Insurance Cancellations
By extending the policy that long — potentially letting consumers keep plans that aren’t Obamacare-compliant until the fall of 2017 — the administration says it should avoid another wave of dropped insurance policies (Condon, 3/5).

USA Today: People May Keep Old Health Insurance Another Year
The change represented another midcourse correction for the law, which is still recovering from the flawed opening of the federal and state health care exchanges last Oct. 1 and the delay of several key provisions (Kennedy, 3/5).

Fox News: Administration Offers 2-Year Obamacare Extension For Canceled Health Plans
The Obama administration announced Wednesday that it will let people keep health insurance plans that would otherwise be out of compliance with ObamaCare for another two years, in a delay Republicans portrayed as an election-year ploy (3/5).

The Wall Street Journal: Latest Health-Law Changes Affect Consumers, Insurers, Employers
The Obama administration unveiled a slate of health-law changes Wednesday, including stretching the enrollment period for next year’s plans an extra month and fine-tuning a financial backstop meant to limit insurers’ losses if they end up with sicker customers than expected. Some of the shifts compensate for a series of earlier policy changes as the Obama administration responded to criticism over the glitchy launch of the Affordable Care Act and a wave of health-plan cancellations. Others, such a new threshold for out-of-pocket medical expenses, give insurers the tools to begin setting prices for 2015 plans (Weaver and Francis, 3/5).

The Washington Post: Obama Administration Permits Further Delay To Health Exchanges For Small Businesses
The Obama administration on Wednesday gave states more time to implement a key feature of the new employer health care marketplaces and gave small businesses more time to comply with some of the new coverage requirements in the law. Under the Affordable Care Act, states are required to offer a health care exchange where small businesses can enroll in and pay for insurance plans, all online. Companies in states that declined to build their own portals would be able to access a similar network run by the federal government (Harrison, 3/5).

Competition Key Ingredient To Success Of State Health Exchanges

Topics: Insurance, Marketplace, Medicaid, Health Reform, States

Apr 23, 2013

Stateline reports that even some of the strongest health exchange
enthusiasts are concerned that some states will still only have limited
insurance choices for consumers. Meanwhile, in other news, the Arkansas
Medicaid expansion model gains momentum, Florida’s efforts face
continued complications, Arizona’s expansion standoff continues and the
Missouri Senate rejects the concept. Also, the shape of Ohio’s
compromise exchange is beginning to emerge.

Stateline: Lack Of Competition Might Hamper Health Exchange

The White House sums up the central idea behind the health care
exchanges in the new federal health law with a simple motto: “more
choices, greater competition.” But even some stalwart supporters of the
Affordable Care Act worry that in many states, people won’t have a lot
of health insurance choices when the exchanges launch in October. Health
economists predict that in states that already have robust competition
among insurance companies—states such as Colorado, Minnesota and
Oregon—the exchanges are likely to stimulate more. But according to
Linda Blumberg of the Urban Institute, “There are still going to be
states with virtual monopolies” (Vestal, 4/23).

Health News Florida: ‘Private Option‘ Plan, Florida Model, Passes In Ark.

Arkansas’ state legislature passed a model plan to expand Medicaid last
week, even though its Legislature is dominated by Republicans and the
measure had to pass by a three-quarters vote, the Associated Press
reports. The Arkansas plan is the model for Florida state Sen. Joe
Negron’s plan, which would accept an estimated $51 billion in federal
funds over 10 years to expand insurance to about 1 million of the
state’s low-income uninsured (Gentry, 4/22).

Miami Herald: Legislators Poised To Adjourn With No Medicaid Plan

As the clock winds down on the legislative session, Florida lawmakers
are sending signals that they are likely to adjourn without resolving
the issue of whether to accept federal Medicaid money to insure the
state’s poorest residents. “It’s not something you put together in a
week,”’ said Sen. John Thrasher, R-St. Augustine, chairman of the Senate
Rules Committee and a close adviser to Senate President Don Gaetz.
“It’s a very big, complicated issue and these issues take some time.” He
said he does not expect there would be political repercussions if the
Republican-led Legislature waits another year (Klash, 4/22).

Arizona Republic: Brewer, GOP In Medicaid Standoff

Three months after she stunned political observers and made her case for
expanding Medicaid coverage in Arizona, Gov. Jan Brewer is no closer to
reaching agreement with Republican legislative leaders on the issue,
which has driven a wedge through GOP ranks and is delaying work on the
state budget. By most accounts at the Capitol, Brewer has just enough
votes in the House and Senate to get expansion approved. Even some
lawmakers who oppose the plan predict it eventually will pass, owing in
large part to the power of the governor’s veto pen and her reputation
for tenacity, as well as pressure from top-flight lobbyists and
heart-tugging health-care crisis stories (Reinhart, 4/22).

The Associated Press: Mo. Senate Votes Down Federal Medicaid Expansion

Republican senators have made it clear that there will be no Medicaid
expansion in Missouri this session. The Republican-led Senate voted down
a Democratic attempt Monday night to insert $890 million of federal
funds into Missouri’s budget to expand Medicaid eligibility to an
estimated 260,000 lower-income adults (4/23).

Cleveland Plain Dealer: Ohio’s Medicaid Expansion Alternative Could Use Private Insurance

For the first time since Gov. John Kasich won national attention by
supporting Medicaid expansion, a clear picture is emerging on how the
Republican governor’s compromise with federal regulators could work.
Some uninsured Ohioans would be enrolled in the state’s traditional
Medicaid program, while others would sign up for private health
insurance using federal funding, said Greg Moody, director of Ohio’s
Office of Health Transformation. The proposal, which Kasich hopes to
sell to GOP lawmakers reluctant to support an outright Medicaid
expansion, has been dubbed “The Ohio Plan.” And it differs from the
standard federal expansion program on one crucial point: It puts some
enrollees in the private insurance market (Tribble, 4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

John Kasich (Photo credit: Wikipedia)

Insurer Centene: We Can Do Arkansas-Style Medicaid

English: House Bill and Senate Bill subsidies for health insurance premiums. (Photo credit: Wikipedia)

By Jay Hancock

April 23rd, 2013, 3:33 PM

Arkansas
is the latest and perhaps best hope for those who want states resistant
to the Affordable Care Act’s Medicaid expansion to reconsider.

Illustration by Darwinek via Wikimedia Commons

Last week the Arkansas legislature approved
a plan to give Medicaid beneficiaries money to buy individual policies
from private insurers on the state’s health insurance exchange — the
subsidized, online markeplaces due to be in business next year. The
governor signed the bill Tuesday — making it law.

The Department of Health and Human Services, which has said it “will consider approving a limited number” of such arrangements, still needs to negotiate details and sign off.

One insurer is already expressing interest.

“We
are very capable of doing an Arkansas-type model,” Centene Corp. CEO
Michael Neidorff said Tuesday. “That’s something that would be a sweet
spot for us.”

Centene sees opportunity in participating in the
health law’s coverage expansions, whether Arkansas-style or not. It
already runs Medicaid managed care plans for those with very low incomes
in several states, although not in Arkansas. Now it wants to offer
plans to individuals with slightly higher incomes through the exchanges.

“We
believe we can achieve increased profitability in 2014 upon the
commencement of the ACA,” Neidorff told stock analysts Tuesday. “The
exchange market represents the largest growth opportunity for Centene
over the next several years, estimated at $52 billion in our existing
markets.”

Policy analysts expect considerable “churn”
from members moving between the ACA’s expanded Medicaid program and
commercial policies sold on the exchanges as their incomes fluctuate.
Centene wants to be on both sides of the line, selling “a product that
offers people a comfortable transition,” said K. Rone Baldwin, chief of
the company’s insurance group.

Whether managed by Centene or some
other carrier, private, individual insurance in the Arkansas mode could
help Medicaid members keep the same doctor and otherwise minimize
disruptions when they graduate to a non-Medicaid exchange plan, some
have suggested.

The Arkansas model faces large questions. Not least are those about cost.
Commercial insurance of the type Arkansas sees covering Medicaid
members typically pays doctors and hospitals more than traditional
Medicaid or Medicaid managed care plans like Centene runs.

But the plan is being praised as a “conservative alternative” to Obamacare classic and is reportedly being eyed by Pennsylvania, Ohio and other states resisting the Medicaid expansion.

Centene
executives spoke to investment analysts on a conference call about the
company’s quarterly profits. Like other insurers, they were coy about
saying where they plan to offer exchange plans and on what terms.

“We
do expect to be on the exchanges in a subset of the places where we
have health plans today, and we’re entering into contracts with
hospitals,” said Baldwin. How well will Centene be paying those
hospitals to care for its exchange members? “It’s certainly not exactly
at [lower] Medicaid rates but I wouldn’t say it’s exactly at [higher]
commercial rates either,” he added.

The company earned $23 million for the quarter on revenue of $2.5 billion.

Issa Threatens To Subpoena HHS Medicare Advantage Documents

English: Congressman Darrell Issa’s Official 111th Congressional Photograph (Photo credit: Wikipedia)

Topics: Politics, Quality, Health Reform

Sep 28, 2012

Rep. Darrell Issa, R-Calif., chairman of the House Oversight and Government Reform Committee, alleges that the Department of Health and Human Services is using an $8 billion Medicare bonus payment demonstration project to mask the health law’s cuts to Medicare Advantage plans in advance of the election.

The Hill: Rep. Issa Threatens To Subpoena HHS Over Medicare Bonuses
Rep. Darrell Issa (R-Calif.) said Thursday that he’s willing to subpoena documents from the Health and Human Services Department (HHS), alleging a conspiracy to hide the impact of President Obama’s health care law. Issa, as chairman of the House Oversight and Government Reform Committee, is investigating an $8 billion demonstration project in which Medicare pays bonuses to certain private Medicare Advantage plans based on quality. The congressman has suggested that HHS is using the bonus payments to mask the health care law’s cuts to Medicare Advantage plans ahead of the election. Issa and Rep. James Lankford (R-Okla.) requested documents about the bonus payments in August. They said Thursday that they haven’t gotten a response and said they “will consider the use of compulsory process” if HHS doesn’t turn over the documents by Oct. 5 (Baker, 9/27).

CQ HealthBeat: Issa Threatens To Force CMS To Turn Over Medicare Advantage Documents
The chairman of the House Oversight and Government Reform Committee is threatening to force Centers for Medicare and Medicaid Services officials to turn over documents relating to their authority to issue bonus payments to Medicare Advantage plans under a CMS demonstration program. Rep. Darrell Issa, R-Calif., said in a letter to Health and Human Services Secretary Kathleen Sebelius that he wants the documents by Oct. 5. “If the Department continues to ignore the Committee’s request, we will consider the use of a compulsory process,” Issa wrote (9/27).

In other Capitol Hill news —

The Hill: Dems Warn Implanted Medical Devices Prone To Hacking
Democratic lawmakers are sounding the alarm on a new hacking threat — to your pacemaker. In a statement Thursday, three House Democrats called on the Food and Drug Administration (FDA) to scrutinize implantable medical devices more carefully. The lawmakers cited government research showing devices such as cardiac defibrillators and insulin pumps can be vulnerable to tampering because of their wireless capabilities. “Even the human body is vulnerable to attack from computer hackers,” said Rep. Anna Eshoo (D-Calif.). “The demonstrated security risks require a renewed emphasis by the FDA and manufacturers to identify, evaluate and plug the potentially rare but serious security holes that exist in these devices” (Viebeck, 9/27).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: Logo of the . (Photo credit: Wikipedia)

White House Details The Reach Of Automatic Spending Cuts

Topics: Health Costs, Hospitals, Medicare, Medicaid, Politics

Sep 15, 2012

In a report issued Friday, the Obama administration outlined the budget accounts which would be touched by sequestration’s automatic spending reductions. Although Medicare benefits are exempt, a 2 percent cut would be imposed on Medicare provider payments.

Kaiser Health News: Automatic Budget Cuts Will Reduce Medicare Payments To Providers By $11 Billion
Medicare providers would see reductions of about $11 billion beginning in January as part of series of automatic spending cuts set to begin next year unless Congress acts to halt them, according to estimates released Friday by the White House Office of Management and Budget. The numbers came in a report that details how federal agencies would implement roughly $110 billion in mandatory, across-the-board budget cuts agreed to by Congress and President Barack Obama last August as a way to end a bitterly partisan dispute over raising the debt ceiling. Lawmakers in both chambers, as well as Obama, want to avoid the automatic cuts that would trim federal spending by $2.1 trillion over the next 10 years, called sequestration (Carey, 9/14).

Kaiser Health News also has a copy of the full report.

USA Today: White House Warns Of Massive Defense, Domestic Cuts
The cuts are threatened under terms of last year’s deficit reduction law, which trimmed $1.1 trillion from federal spending over 10 years and mandated another $1.2 trillion — without saying how to do it. A bipartisan committee tasked with that challenge failed. Now Congress has four months remaining to avoid the automatic cuts. If it fails — and as of now, Obama and Republicans are at loggerheads, with the election less than eight weeks away — defense spending would be cut by 9.4%, non-defense spending by 8.2%, most entitlement programs by 7.6% and Medicare providers by 2% (Wolf, 9/14).

Politico: White House: Sequester ‘Deeply Destructive’ To Defense
The report confirms in painstaking detail which budget accounts are subject to cuts — down to the congressional visitors center — and which are exempt. And it is likely to add new urgency to efforts to stop the cuts from taking effect. “No amount of planning can mitigate the effect of these cuts. Sequestration is a blunt and indiscriminate instrument. It is not the responsible way for our nation to achieve deficit reduction,” the Office of Management and Budget wrote. “The report leaves no question that the sequestration would be deeply destructive to national security, domestic investments and core government functions” (Wright and Allen, 9/14).

The Washington Post: White House: Dire Cuts For Military, Domestic Programs As U.S. Steps Toward Fiscal Cliff
The report tracks the level of cuts for 1,200 separate budget line items, taking account of rules Congress agreed to last summer that shield certain priorities, including food stamps and Medicaid benefits. Salaries for military personnel are also exempt, as are Medicare benefits, though Medicare providers would take a 2 percent hit (Helderman, 9/14).

The Wall Street Journal: Federal Budget Cuts Detailed
The White House ticked through the federal budget line by line in the report, showing how a roughly 9% reduction in spending on military and other programs would affect government operations. There would also be a 2% cut in payments to Medicare providers, equal to $11 billion a year, the report says. … The White House and Democrats want any deal to include more tax revenue, while many Republicans want to block the cuts to military programs and make more reductions on social programs like food stamps (Paletta, 9/14).

The New York Times: White House Details Potential Effects If Automatic Budget Cuts Go Through
Lawmakers still hope that Congress and the White House can come up with a way to avoid the cuts, but nothing will happen before the November elections, whose outcome will have some effect on what any future agreement would look like. For now, the two parties remain at odds, with each seeking to blame the other for the automatic cuts about to come. Under the terms of those cuts, most military programs face a 9.4 percent reduction, while most domestic programs would be sliced by 8.2 percent. Medicare would be trimmed by 2 percent, while other social programs — excluding Social Security — would be sliced by as much as 10 percent (Weisman, 9/14).

The Los Angeles Times: White House Warns Of ‘Deeply Destructive’ Budget Cuts
Still, the report puts a finer point on what is coming if Congress doesn’t act. Medicare payments to providers would be cut by 2%, or $11 billion, next year. More than $540 million would be cut from food stamps. Financial aid for college would be cut by $140 million. The National Institutes of Health would take a $2.5-billion cut. The report says embassy security, construction and maintenance would be cut by $129 million. Social security, military personnel, Veteran’s Administration and Medicaid are exempt from cuts (Hennessey, 9/14).

The Hill: White House Details Automatic Budget Cuts, Calls Them ‘Blunt, Indiscriminate’
The assessments made in the sequestration analysis are strictly “preliminary” and based on fiscal year 2012 spending levels, the White House said. “The Administration continues to urge Congress to avoid … sequestration through the enactment of bipartisan balanced deficit reduction legislation,” the report states (Muñoz, 9/14).

The Washington Times: White House Details ‘Destructive’ Spending Cuts
With excruciating detail, the White House on Friday laid out exactly where it will have to cut $109 billion from federal spending in January, including $11.1 billion from Medicare and $54.7 billion from defense spending. … These are among the findings in a new 394-page report by the White House that was delivered Friday to Congress, detailing line by line what will happen next year if Washington fails to act to head off about $100 billion in military and domestic spending cuts scheduled to begin Jan. 2. Also facing slashes are the National Institutes of Health, which would see a $2.5 billion cut, and the Centers for Disease Control and Prevention, which would have to trim $464 million, according to the 394-page report (Dinan, 9/14).

Reuters: Automatic U.S. Spending Cuts Destructive: Administration
In submitting the details of the automatic spending cuts, the White House used the occasion to attack Republicans in Congress for offering only “unbalanced solutions” that it said were not “realistic, fair or responsible ways” to avoid the $109 billion meat-axe approach. This was in response to months of Republican claims that they had approved an alternative in the House of Representatives that the Democratic Senate has ignored (Felsenthal and Shalal-Esa, 9/14).

Marketwatch: Budget Sequester Would Be Devastating: White House
Automatic spending cuts set to begin in January would have a “devastating” effect on both defense and domestic programs, the White House’s Office of Management and Budget said in a report on Friday (Schroeder, 9/14).

Bloomberg: Obama Warns Congress of ‘Devastating’ Cuts in Report
An Obama administration report cataloguing the impact of $1.2 trillion in looming spending cuts illustrates the stakes as lawmakers debate what to do about the U.S. deficit less than two months before the election. The White House budget office said the cuts, known as sequestration and set to start in January, would undermine economic investment and cause “severe harm”to initiatives including food-safety inspections, air-traffic control and support for schools (Faler and Runningen, 9/15).

National Journal: White House Unveils Sequestration Plan
Two programs established in the 2010 Affordable Care Act would be protected from cuts — funding for an insurance pool for “high-risk” patients who were denied coverage due to a preexisting condition and a that aims to get consumer insurance exchanges off the ground (O’Donnell, Sorcher and McCarthy, 9/14).

UPI: OMB: Cuts Would Be ‘Deeply Destructive’
The across-the-board cuts are mandated by the Sequestration Transparency Act, part of a deal worked out to end last year’s U.S. debt-ceiling crisis. A congressional Joint Select Committee on Deficit Reduction, known as the supercommittee, was required to identify about $1.2 trillion in cuts to reduce the federal deficit. If it failed, then Congress could increase the debt ceiling but $1.2 trillion — but that would trigger the sequestrations at the center of Friday’s report by the White House Office of Management and Budget (9/14).

National Journal: Sequester Benefits Neither Party, Congressional Insiders Say
Congress is not expected to make any serious maneuvers to offset looming cuts to the defense sector before the fall elections, making the issue a political football heading into November. So which party has the political advantage? Neither, according to the muddled results from National Journal’s latest Congressional Insiders poll (Goldmacher and Bell, 9/14).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: Medicare and Medicaid as % GDP Explanation: Eventually, Medicare and Medicaid spending absorbs all federal tax revenue, which has averaged around 19% of GDP for the past 30 years. Category:Health economics (Photo credit: Wikipedia)

Judge Finds Texas Can End Planned Parenthood Funding Before Final Ruling

Topics: Women’s Health, States, Delivery of Care

Aug 22, 2012

A federal judge ruled Tuesday that Texas can cut off funding to Planned Parenthood before a ruling is made on the legality of the Texas legislature’s law banning funding to the provider of women’s health services over its abortion services.

Los Angeles Times: Texas Can Cut Planned Parenthood Clinic Funding, Judges Rule
Texas can cut off funds for Planned Parenthood clinics before a trial concerning the legality of its ban on funding organizations tied to abortion providers, a federal appeals court ruled Tuesday. The U.S. 5th Circuit Court of Appeals in New Orleans lifted a federal judge’s temporary injunction that had protected the funding pending an October trial (Hennessy-Fiske, 8/21).

The Associated Press/New York Times: Women’s Clinics In Texas Lose Aid
A federal appeals court ruled on Tuesday that Texas can end financing for Planned Parenthood clinics that provide health services to low-income women before there is a trial over a new law that bars state money from going to organizations tied to abortion providers (8/21).

The Associated Press/Houston Chronicle: Court: Texas Can Cut Off Planned Parenthood Funds
Texas officials are vowing to cut off funding for Planned Parenthood after a federal court sided with the state in a challenge over a new law that bans clinics affiliated with abortion providers from getting money through a health program for low-income women. The 5th U.S. Circuit Court of Appeals in New Orleans late Tuesday reversed a federal judge’s temporary injunction that was allowing the funding to continue pending an October trial on Planned Parenthood’s challenge to the law. State officials are seeking to halt money to Planned Parenthood clinics that provide family planning and health services as part of the state’s Women’s Health Program because the Republican-led Texas Legislature passed a law banning funds to organizations linked to abortion providers (Weissert, 8/22).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Texas Medical Center (Photo credit: slight clutter)

Do Akin’s Rape Comments Put GOP Ticket In Harm’s Way?

Official photographic portrait of US President Barack Obama (born 4 August 1961; assumed office 20 January 2009) (Photo credit: Wikipedia)

Topics: Women’s Health, Politics

Aug 21, 2012

News outlets analyze the potential repercussions to Mitt Romney‘s presidential bid by the statements made by Missouri Republican Senate candidate Todd Akin. Also examined is presumptive GOP vice presidential nominee Paul Ryan’s co-sponsorship of legislation with Akin, including one that would give legal protection to an embryo.

National Journal: Could Akin Damage The Top Of The GOP Ticket?
Akin and Paul Ryan, House GOP colleagues, share a voting history on abortion rights, including mutual support for a controversial measure that would define embryos as a person. They cosponsored another measure, subsequently withdrawn, that would distinguish “forcible rape” in banning abortion funding. Akin, Ryan, and Mitt Romney also back less-controversial measures, such as defunding Planned Parenthood. That broader link gives Democrats a chance to push a debate about abortion and women’s health back into the presidential race’s limelight, putting the GOP ticket on the defensive over an issue it would rather avoid and with a group of voters, females, it has already struggled to attract (Roarty, 8/21).

Politico: Mitt Romney’s Run From Todd Akin At Odds With Paul Ryan
The Romney campaign statement on Sunday keeps with the presumptive nominee’s current position on abortion, which is in support of a ban with exemptions. But it is in clear contrast to Ryan’s past embrace of a view that no pregnancy should be terminated after fertilization. Like Akin, Ryan is a co-sponsor of the “Sanctity of Human Life Act,” a so-called personhood measure that defines life as beginning at “fertilization, cloning or its functional equivalent” and empowers the federal and state governments to pass laws to protect life from that point on. The bill makes no exception for rape. Ryan has voted in favor of a restriction on federal funding for abortions — known as the Hyde Amendment — that includes exceptions when a pregnancy results from rape or incest, or endangers the life of the mother (Allen, 8/20).

ABC (Video): Todd Akin’s Rape Comments May Have Repercussions For Mitt Romney
While most of the debate over Ryan’s policies have centered on his budget and proposed Medicare reforms, Akin’s comment threatens to place the focus on social issues for Romney’s new running mate. Republicans’ eagerness to speak out against Akin may indicate that his comments tapped into a larger issue in the campaign. Democrats have previously taken aim at Romney’s socially conservative stances and their effects on women. Akin’s comments on rape threaten to distract from Romney’s message about a lagging economy and President Obama’s health care and stimulus plans, as well as blunt the buzz about Ryan’s recent selection as vice presidential nominee or the run-up to next week’s Republican National Convention in Tampa, Fla. (Good, 8/20).

The Hill: President Obama: ‘Rape Is Rape’
President Obama on Monday called Rep. Todd Akin’s remarks about rape “offensive” and sought to tie the Republican Senate candidate to the GOP presidential ticket. “Rape is rape,” Obama said at a White House press briefing. He called Akin’s comments “way out there.” Defining rape, he said, “doesn’t make sense to the American people and doesn’t make sense to me.” “What I think these comments do underscore is why we shouldn’t have a bunch of politicians, the majority of which are men, making decisions that affect health of women,” Obama said (Easley and Parnes, 8/20).

The New York Times: As Romney Enjoys Ryan’s Spark, Rivals Try To Fan It
But Mr. Ryan also brings a record in Congress that sets him apart from Mr. Romney, and on Monday his opposition to abortion, even in cases of rape and incest, offered a reminder of the political dangers that sometimes come from embracing a running mate and his record. Already, Mr. Ryan’s proposals to change Medicare had drawn attacks from President Obama and his Democratic allies. The ticket was forced to address abortion after Representative Todd Akin, the Republican Senate candidate in Missouri, said in an interview on Sunday that women’s bodies had ways to block unwanted pregnancies (Shear and Gabriel, 8/20).

The Texas Tribune: Unlike Romney, State Leaders Oppose Abortion After Rape
The state’s Republican leaders are at odds with the presumptive GOP presidential ticket on one key element of abortion politics — whether they oppose the procedure for victims of rape. Mere hours after U.S. Rep. Todd Akin, R-Mo., and an ardent opponent of abortion in almost all cases, made comments on Sunday suggesting that women’s bodies would naturally reject pregnancy in cases of “legitimate rape,” Mitt Romney and Paul Ryan released a statement distancing themselves from him. They said their administration “would not oppose abortion in instances of rape” (Ramshaw, 8/21).

Meanwhile, doctors challenge Akin’s views –

St. Louis Beacon:  Experts On Reproduction Challenge Akin’s Views On Pregnancy Following A Rape
Science and research don’t seem to be on the side of Rep. Todd Akin when he argues that rapes rarely result in pregnancies. … Hile points to one often quoted study, in the journal Human Nature, which concludes that the incidence of pregnancies growing out of rapes was twice as high as other pregnancies. The authors of that study found that “even before adjusting for birth control usage, per-incident rape-pregnancy rates (6.42 percent) are notably higher than per-incident consensual pregnancy rates (3.1 percent)” (Joiner, 8/20).

Kansas City Star: Doctors Dispute Akin’s Claim, But Some Supporters Say It Was Misunderstood
Michael Weaver, an emergency medicine physician at St. Luke’s Hospital and medical director of the forensic care program at St. Luke’s Health System, said Akin was wrong. “To try to be able to say that anyone’s going to respond in a consistent pattern that’s going to limit their probability of becoming pregnant is ridiculous,” Weaver said. But Tim Wildmon, president of the American Family Association — a nonprofit that describes itself as a pro-family organization — told The Star on Monday that “fair-minded people” know what Akin really meant by his statement. Wildmon speculated that Akin was differentiating between forcible rape and statutory rape, which can be consensual (Shastry, 8/20).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Polls: Opposition To Changing Medicare Cuts Across Party Lines

Mitt Romney Steve Pearce event 057 (Photo credit: Wikipedia)

Topics: Health Costs, Medicare, Politics

Aug 17, 2012

Two polls, one conducted by the Kaiser Family Foundation, and another conducted by KFF and the Washington Post, find that a majority of Republicans and Democrats oppose plans to cut Medicare benefits or transform the program into a “definied-contribution” model.

Reuters: U.S. Voters See Medicare As a Top Election Issue: Poll
Medicare has become a top healthcare issue in the U.S. presidential election, surpassing the controversy over President Barack Obama’s healthcare law, according to a poll conducted just as Republican Mitt Romney pushed the issue to the forefront of the campaign with his choice of running mate. On Saturday, Romney announced he had picked Representative Paul Ryan, a lawmaker whose plan to cut billions of dollars from the U.S. deficit included transforming the costly, but popular, healthcare program for the elderly (Morgan, 8/16).

Kaiser Health News: Capsules: Don’t Change Medicare, Most Republicans Say In Poll
As Rep. Paul Ryan‘s plan to overhaul Medicare makes campaign headlines, a majority of Republicans oppose changing the government program for seniors, according to a new poll by the Kaiser Family Foundation and the Washington Post. (KHN is an editorially independent program of the foundation.) That could spell trouble for presumptive presidential nominee Mitt Romney and his designated  running mate Ryan as voters focus on the Wisconsin congressman’s ‘premium support’ plan (Hancock, 8/16).

CQ HealthBeat: Opposition To Cutting Medicare Benefits, Premium Support Cuts Across Party Lines
In a rare moment of near-agreement on health care policy this election season, a majority of Republicans and Democrats oppose cutting Medicare benefits or transforming the program into a defined-contribution model, according to one of two polls the Kaiser Family Foundation released Thursday. According to a joint Washington Post/Kaiser survey, which was conducted mostly before presumed GOP presidential candidate Mitt Romney named Rep. Paul D. Ryan, R-Wis., as his vice presidential pick, found that 55 percent of Republicans want to maintain Medicare as it is currently structured and not change it to a system under which seniors get a fixed amount of money with which to buy health insurance (Bunis, 8/16).

Modern Healthcare: Costs, Medicare Top Healthcare Issues For Voters, Poll
The cost of both healthcare and health insurance, followed by Medicare, are the top healthcare concerns on the minds of voters in all political parties, according to an August tracking poll from the Kaiser Family Foundation. When asked about the top healthcare policy issues in this campaign season, 78% of Democrats, 73% of Independents and 67% of Republicans listed the cost of healthcare and health insurance as either extremely or very important to their vote for president (Zigmond, 8/16).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Analysis: App-Happy Health Care Full of Optimism, Money

Topics: Health IT, Delivery of Care, Marketplace, Public Health, Quality

By Michael L. Millenson

Aug 01, 2012

Michael L. Millenson is a Highland Park, Illinois-based consultant, a visiting scholar at the Kellogg School of Management and the author of Demanding Medical Excellence: Doctors and Accountability in the Information Age. 

There is a corner of the health care industry where rancor is rare, the chance to banish illness beckons just a few mouse clicks away and talk revolves around venture deals, not voluminous budget deficits.

Welcome to the realm of Internet-enabled health apps. Politicians and profit-seeking entrepreneurs alike enthuse about the benefits of “liberating data” – the catch-phrase of U.S. Chief Technology Officer Todd Park – to enable it to move from government databases to consumer-friendly uses. The potential for better information to promote better care is clear. The question that remains unanswered, however, is what role these consumer applications can play in prompting fundamental health system change.

Michael W. Painter, a physician, attorney and senior program officer at the Robert Wood Johnson Foundation, is optimistic. “We think that by harnessing this data and getting it into the hands of developers, entrepreneurs, established businesses, consumers and academia, we will unleash tremendous creativity,” Painter said. “The result will be improved and more cost efficient care, more engaged patients and discoveries that can help drive the next generation of care.”

The foundation is backing up that belief with an open checkbook. RWJF recently awarded $100,000 to Symcat, a multi-functional symptom checker for web and mobile platforms. Developed by two Johns Hopkins University medical students, the app determines a possible diagnosis far more precisely than is possible by just typing in symptoms as a list of words to be searched by “Dr. Google.” Symcat also links to quality information on different providers and can even direct users to nearby emergency care and provide an estimate of the cost.

Symcat received its check in early June at the Health Data Initiative Forum, an event where the  upbeat tone was reflected in its official nickname, Datapalooza. Sponsored by the Department of Health and Human Services and the Institute of Medicine, the first such meeting in 2010 fit into a cozy auditorium. This year’s gathering drew nearly 1,500 attendees to the Washington Convention Center to discuss how consumer-friendly data could disrupt old ways of delivering health care information.

The federal government plays multiple roles in that effort as convener, innovator, cheerleader and facilitator, the latter through an aggressive program to open up data to the private sector. Symcat, for instance, draws on disease prevalence data from the Centers for Disease Control and Prevention. Other presenters and exhibitors showed off new efforts to apply these federal resources to help anticipate asthma attacks, make diabetes care more effective and improve survival estimates in cancer patents.

The intense interest in consumer health IT comes in response to “an increasingly health care ‘do-it-yourself’ world,” notes economist Jane Sarasohn-Kahn. From a third to a little under half of U.S. adults now use health-related blogs, social networks, ratings websites or apps. Health and medical apps for the iPhone now target fitness, stress, chronic disease, mental health, smoking cessation and medication adherence, to name just some categories tracked by MobiHealthNews.

Funding has followed the crowd, with investments in health information apps up a reported 78 percent in just two years to $766 million, and the average start-up pulling in nearly $12 million. The medical app market, already growing faster than the general apps, will grow 25 percent annually over the next five years, according to one research firm’s estimate.

Despite the buoyant marketplace, it remains to be seen whether the effectiveness of individual apps will match the enthusiasm. While MobiHealthNews counted nearly 14,000 health- and medical-related iPhone apps as of April, the reliability of any particular app or even category of apps is hard to determine. One research group recently recommended that both content and user interface be tailored as necessary to respond to cultural differences among different racial and ethnic groups. Separately, another group of researchers examining web-based tools to help consumers control their diabetes concluded earlier this year that “few tools … met our criteria for effectiveness, usefulness, sustainability and usability.”

That uncertainty shadowing this fast-evolving field is one reason the Food and Drug Administration wants to regulate medical apps it believes could present a risk to patients if they don’t work as intended. That sentiment prompted a backlash among that fearful bureaucratic caution would block innovation. In mid-July, President Obama signed bipartisan legislation that, among other provisions, calls on HHS to report to Congress on an “appropriate, risk-based regulatory framework pertaining to health information technology, including mobile medical applications.” FDA is expected to release guidelines reflecting its thinking by year-end.

Opening up new information sources to patients will also affect the traditional doctor-patient relationship. There is growing activism by some patients who don’t want to wait to become full, engaged partners in their care. For instance, Hugh Campos, who has long-standing heart problems, received national attention for demanding access to the data feed from his pacemaker. At the same time, some physicians wonder whether this level of involvement truly represents a trend. In a recent National Public Radio interview, Dr. Arnold Relman, former editor of the New England Journal of Medicine, said he had “some reservations about the depiction of a future patient who is consumed by constantly watching [remote] sensors talk to his smartphone. I don’t think that patients are going to be motivated to do that all the time.”

A recent survey found that about one in 5 mobile phone users search for health information. And experts caution that lasting behavior change is often blocked by barriers as much psychological as informational. An app whose interface is appealing isn’t the same as one that’s effective.

Jessie Gruman, a four-time cancer survivor who heads the Center for Advancing Health, points out that “keeping ourselves alive and out of pain is a serious business.” Those who are sick don’t need apps that are fun, says Gruman. Rather, “we want a technology that is efficient and useful –one that will help us take care of ourselves so that we can live lives that are fun.”

Im Proud to be part of this!

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We are proud to announce that in 2011, IAB members saved OVER 21 MILLION DOLLARS in medical savings and paid medical benefits! We thank all of our members for making IAB, America‘s Premier Membership Association!