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Summaries of health policy coverage from major news organizations

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Tuesday, May 31 2016

Full Issue

Viewpoints: Rising Premiums; Paying More After Mergers; VA Nurses

A selection of opinions on health care from around the country.

Obamacare's enemies are gearing up to make rising health insurance premiums a major attack point during the coming election season. One of their talking points will be a disingenuous generalization derived from the double-digit rate hikes that some insurers in some parts of the country are seeking for the individual plans they sell on the exchanges. Few people will hear or understand that those rising rates apply only to individual plans sold on the exchanges, which comprise less than 10% of covered lives with private insurance. They will look only at their own rising coinsurance, copays and deductibles in their employer-provided plans鈥攚hich cover over 150 million people鈥攁nd incorrectly blame Obamacare. (Merrill Goozner, 5/28)

We know all about the benefits in store for us when big hospital chains merge and bigger health insurance companies grow even bigger: Lower prices. More efficient healthcare. More innovation. Better customer service. That's what hospital and insurance companies say, anyway. But here's what the data say: Hospital and insurance mergers almost always lead to higher costs, lower efficiencies and less innovation. The reason is simple: Mergers reduce competition. (Michael Hiltzik, 5/27)

A federal district judge ruled this month, in a lawsuit brought by House Republicans, that the Obama administration lacks the authority to pay cost-sharing subsidies to health insurers if Congress has not appropriated the funds. Some civil servants in the administration may agree. The House Ways and Means Committee released a deposition Tuesday of David Fisher, former chief risk officer for the Internal Revenue Service. In it, Mr. Fisher recounts a series of events in late 2013 and early 2014 regarding the source and legality of Obamacare cost-sharing subsidies to insurers. (Chris Jacobs, 5/27)

For five issues, the Democratic position is much more popular than either the neutral or the Republican position. Those include increased taxes on high earners, legalizing abortion in cases of rape and incest, having anti-discrimination laws for sexual orientation, federally mandating that businesses offer maternity leave and increased gun control measures. For two issues, the Democratic position and the neutral position are equally popular: whether the government should try to reduce income inequality and whether global warming exists. American voters are decidedly neutral on two issues associated with Republicans: reducing Medicare costs by giving vouchers to subscribers and curtailing government regulations. (Tobias Konitzer and David Rothschild, 5/27)

The U.S. Department of Veterans Affairs hasn鈥檛 exactly been a model of efficient health care in recent years. But its new proposal to expand the role of nurses is a good idea that should be widely copied. (5/26)

Americans expect and deserve a more efficient and effective military defense from such threats 鈥 better, at least, than what the active duty military provided during the 2014 Ebola crisis. The response then turned out to be poorly executed and too late. Now facing Zika, the director of the Centers for Disease Control and Prevention says he鈥檚 interested in 鈥渘ewer tools.鈥 Luckily we have a ready-made bullpen of military first responders: the National Guard. (ML Cavanaugh, 5/27)

Courtroom 1E is like a big, open confessional. 鈥淭his is almost like the truth court,鈥 said Marshall Williams, a retired Army sergeant major who decided to scrap all the platitudes he鈥檇 planned to say in that Northern Virginia courtroom last week and instead tell the truth. The truths told there in Fairfax County District Court are usually personal and embarrassing. They include the truth about dodging gunfire, watching people die, dousing the nightmares with drugs or alcohol, trying to get out of bed every day when you鈥檙e a U.S. military veteran fighting the physical and mental toll of your service. This truth court is an experiment 鈥 Fairfax鈥檚 first Veterans Treatment Court program. (Petula Dvorak, 5/30)

Women in California who don鈥檛 want to wait to get birth control prescriptions from their doctors can now purchase their pills, patches, rings and shots directly from pharmacists. The new program, which began earlier this month, has been widely hailed as a victory for women鈥檚 reproductive rights by doctors鈥 organizations and healthcare advocates. Yet the fanfare misses an important point: Women visiting their pharmacists won鈥檛 have access to the most reliable forms of birth control on the market because those methods, such as implantable rods or intrauterine devices (IUDs), will still require a trip to a doctor's office. (Sarah Elizabeth Richards, 5/28)

Like methadone, Suboxone prevents 鈥渄opesickness鈥 and reduces cravings, without getting you high. It is now the gold standard for opioid addicts in medication-assisted treatment, or M.A.T. A combination of the opioid buprenorphine and the anti-overdose drug naloxone, Suboxone is supposed to give addicts a chance to get their lives together before they taper off it. But Suboxone can get you high if you inject it or snort it or take it in combination with benzodiazepines .... increasingly, law enforcement officials 鈥 and many former addicts and their families 鈥 are ... arguing that Suboxone only continues the cycle of dependence and has created a black market that fuels crime. (Beth Macy, 5/28)

Many women don鈥檛 get insurance from their employers, and, with few exceptions, women in Texas can鈥檛 apply for Medicaid coverage until they鈥檙e pregnant. So they often miss the opportunity for care, such as diabetes treatment or access to contraception, that would help them plan a healthy pregnancy. If diabetes is identified and controlled three to six months before a woman becomes pregnant, for example, she has a lower risk of birth complications. (Adriana Kohler, 5/30)

The Texas Legislature is considering a change to the state鈥檚 Medicaid program that could jeopardize access to epilepsy care by allowing insurers, not physicians, to choose what medications managed care plans would cover. Drug formulary changes, intended to cut costs, often translate into medical complications that hurt the vulnerable beneficiaries served by the Medicaid program and are more costly to the state in the long run. Research shows that access to epilepsy medications leads to greater seizure control and less hospitalizations, and savings from restrictive formularies often lead to greater spending on medical complications that outweigh the savings. (Sindi J. Rosales and Donna Stahlhut, 5/29)

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