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In years when Social Security beneficiaries get no inflation bump, their Medicare premiums can’t go up — except for roughly a third of retirees, who must shoulder all of the burden of rising costs. Consequently, about 15 million seniors are looking at premium spikes of up to 50 percent for Part B, the program that covers outpatient care. A typical increase would be from about $105 per month to $159, according to a Congressional Research Service report. And older Americans are howling in protest, to a Congress that’s already having trouble meeting deadlines regarding the budget and the federal debt ceiling. (10/17)

Last Thursday the Social Security Administration announced next year’s cost of living adjustment for retiree benefits, and the news is not good. Thanks largely to falling gasoline prices, the index used by Social Security to adjust beneficiary payments for inflation is below what it was a year ago. That means no increase in seniors’ monthly Social Security checks. At the same time, millions of seniors will have to pay much higher Medicare premiums. On top of that, every beneficiary will have to pay more up front before Medicare covers their doctors’ bills. Although a political solution would block the increase, the problem will not be solved without structural reforms. (Joseph Antos, 10/19)

It's certainly true that millions of elderly people will face higher premiums for Part B, an optional but essential part of Medicare that covers doctors' charges and outpatient care bills. But it's just not true that nearly one-third of Medicare beneficiaries will face record increases in their premiums. Under federal law, enrollees in Medicare Part B pay one-fourth of its costs, with federal taxpayers essentially covering the rest. ... consider who's in the category being squeezed. The largest segment is nearly 11 million seniors and disabled Americans with incomes so low, they are also enrolled in Medicaid, the joint federal-state insurance program for the impoverished. Medicaid pays their Part B premiums, which means that federal taxpayers will have to fork over about $3 billion more, and state taxpayers about $2 billion. In California, the state's tab could be more than $500 million. (Jon Healey, 10/16)

The idea of Medicaid expansion isn’t going away. Not when the governor is pushing it, and not when he’s getting strategic about how to do that. It’s certainly not going away now that the state is facing up to $200 million in budget cuts. That’s because Gov. Matt Mead understands one key thing: Expanding Medicaid to 17,000 low-income adults is good for Wyoming. (10/18)

Now that the Utah Legislature has rightly rejected (again) a flawed proposal to expand Medicaid under Obamacare, the question is: What do we do now? ... The reason Utahns in the coverage gap do not have health coverage is that they cannot afford it — they are in poverty. Instead of addressing this moral issue, Medicaid expansion largely ignores it and simply tries to relieve one of poverty's symptoms. ... [An alternative] should address the fundamental reasons Utahns are in serious poverty. For a portion of the Medicaid expansion population — commonly referred to as the "medically frail" — this reason is their health status. Giving this targeted group access to Medicaid makes sense, whether that be the current Medicaid program or a targeted, Healthy Utah-style pilot program. (Derek Monson, 10/17)

Failed again is yet another attempt to pass Medicaid expansion and bring back to our state more than $700 million each year in tax money Utahns have already paid to the federal government. The most infuriating twist of this most recent tale was to hear the speaker of the House, Greg Hughes, say that Medicaid expansion would not be considered in our House until 38 House Republicans supported it. Why is that so outrageous? Because it means Utah more closely resembles the former Soviet Union than a democratic republic. (Brian S. King, 10/17)

It is getting harder for some legislators to argue against giving the dignity of affordable healthcare to about 100,000 of our Utah neighbors — especially when the federal government picks up the vast majority of the bill. ... Instead of facing this, somehow, the issue has now become how can this state possibly pay what amounts to about $50 million to $70 million to allow the impoverished access to life sustaining health care. This is about one-half of one-percent of a $14 billion Utah state budget — pocket change when it comes to running a state. (Scott B. Hayashi, 10/16)

The Cadillac plan tax would, if implemented, be a powerful force for containing health care costs, but it would not be painless or without consequences. It would be nice to think that there is some magic pixie dust for controlling health costs. Sadly, that kind of thinking is rooted in fantasy, not reality. Opposition to the Cadillac plan tax is building, on both political and substantive grounds. However, writing its epitaph is still somewhat premature, as there is no consensus on how to replace the revenues it raises or how to constrain health care spending in some alternative way. When a new president takes office in 2017, this may be one of the biggest health care issues awaiting him or her. (Larry Levitt, 10/15)

[I]mproper payments [by federal agencies] are, by definition, indefensible, and they’ve totaled $1 trillion since fiscal 2003, the first year in which the GAO produced a government-wide estimate. That’s not chump change. The battle against them, therefore, is a battle to protect the legitimacy of active government itself. ... This is especially true given the GAO’s finding that three-quarters of the improper payments come from just three programs — Medicare, Medicaid and the Earned Income Tax Credit — all of which are meant to help the elderly and the poor. Nearly 10 percent of Medicare’s $603 billion in outlays last year was improperly paid. (10/18)

Addiction and overdose deaths are seldom the stuff of presidential campaigns, but with an estimated two people dying every hour from overdoses of prescription pain medications, this primary season is different. ... Addiction to pain relievers containing opioids and to heroin — which many medication addicts turn to when opioids become more expensive and harder to obtain — is ravaging communities across the country. In New Hampshire, site of the first presidential primary, overdose deaths from opioids have doubled since 2009 and deaths from heroin have quadrupled. Voters are looking for solutions to an epidemic .... doctors are at the center of the problem and need to be at the center of any solution. Yet, too few have even joined the battle. (10/18)

Prescription drug monitoring programs (PDMPs) are incredibly useful patient safety tools. What health care provider (whether a pathologist or a pediatrician) would not benefit from knowing what controlled substances his patients are taking? However, I am concerned that mandating that clinicians check these databases before prescribing opioid pain relievers would restrict, rather than improve, patient care. (Gregory Terman, 10/18)

There is a way to keep [prescription] prices low while encouraging drug companies to innovate: Look to Europe and elsewhere, where drug prices are a fraction of those in the United States. Germany, Spain, Italy and a half dozen other countries have pushed drug prices lower with a system called reference pricing. ... A study published in the American Journal of Managed Care found that price reductions ranged from 7 percent to 24 percent. (Austin Frakt, 10/19)

[T]hanks to ... vociferous opposition, an increasing number of Americans view vaping as no safer than smoking, which is absurd. And e-cigarette manufacturers like NJOY can’t set them straight: The law giving the Food and Drug Administration regulatory authority over tobacco products, which passed in 2009, prohibits e-cigarette companies from making reduced-harm claims unless they jump through some near-impossible hoops. Thus, NJOY has no way to convey to adult smokers the critical message that e-cigarettes could save their lives. (Joe Nocera, 10/16)

People should be able to take medical leave, particularly during and after pregnancies, without worrying about getting fired or going broke. This is both a humane goal and, given that it promotes healthy childbearing and stable families, an investment in the nation’s future. Federal law in this area falls short. The 1993 Family and Medical Leave Act requires employers to offer 12 weeks of unpaid leave, but the law covers only about 60 percent of workers, according to the Council of Economic Advisers . Moreover, for those whose employers don’t offer paid leave, taking time off may be unaffordable. (10/17)

That ballyhooed new California law allowing terminally ill patients to end their suffering by swallowing a lethal pill won't take effect any time soon. And nobody knows when it will. Conceivably, it might not be until late next year — or even 2017. First, the Legislature must adjourn its special session on healthcare financing. Then 90 days later, the "right to die" act can become real. You probably haven't been paying much attention to the Legislature's special session. Don't feel guilty. Neither has the Legislature. (George Skelton, 10/19)

It’s no great surprise that conservative groups such as Americans for Prosperity are chiming in on the debate over health care regulation in Virginia. The only surprise is that it took them this long. After all, the rules at issue — a system requiring that hospitals and other providers obtain a Certificate of Public Need from the state for new facilities or equipment — provide a costly and an outdated solution to a problem that was solved long ago. (10/18)