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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jan 11 2016

麻豆女优 Health News Original Stories 2

  • Telenovelas, Spanish Website Seek To Inform Hispanics About Kidney Donations
  • Last-Minute Deal May Resolve Dispute Over Managed Care Tax In California

Health Law 4

  • Obama Vetoes Health Law Repeal, Says It Would 'Reverse Significant Progress'
  • IRS: 1.4M Households Failed To Properly Account For Subsidies From Health Law
  • Special Enrollment Periods Drive Up Premium Costs, Insurers Say
  • State Legislatures Brace For Medicaid Expansion Measures

Administration News 1

  • In State Of The Union, Obama To Abandon Sweeping Policy Proposals For Thematic Approach

Women鈥檚 Health 1

  • Abortion Battle Takes Center Stage As N.C. Ultrasound Law Goes Into Effect

Quality 1

  • U.S. May End Program That Entices Cuban Doctors, Nurses Into Defecting While Abroad

Public Health 2

  • NIH Readies For Launch Of Ambitious Precision Medicine Research Project
  • Researchers Say Exercise Can Help Patients With Cancer, Diabetes

State Watch 1

  • State Highlights: California Becomes Ground Zero For Insurance Mega-Merger Scrutiny; Kansas Insurer To End Prior Authorization For Mental Illness Care

Editorials And Opinions 1

  • Viewpoint: GOP's Repeal Bill Could Be A Test-Run; Another Side Effect Of High Deductibles

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Telenovelas, Spanish Website Seek To Inform Hispanics About Kidney Donations

The website Inf贸rmate offers resources and information to help dispel cultural myths that may keep Latinos from becoming live kidney donors. ( Fran Kritz , 1/11 )

Last-Minute Deal May Resolve Dispute Over Managed Care Tax In California

The proposed compromise would avert $1 billion in budget cuts but still must be approved by a two-thirds majority in the legislature. ( Barbara Feder Ostrov , 1/8 )

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Summaries Of The News:

Health Law

Obama Vetoes Health Law Repeal, Says It Would 'Reverse Significant Progress'

Republicans are claiming a victory, nonetheless, as they say it shows what could be possible if they take the White House in 2016.

President Obama vetoed legislation Friday that would have repealed the Affordable Care Act and stripped all federal funds from Planned Parenthood, writing in his veto message that the measure would 鈥渞everse the significant progress we have made in improving health care in America.鈥 Mr. Obama鈥檚 veto 鈥 only the eighth of his presidency 鈥 was expected, and his decision to issue a simple message without holding a public ceremony indicated that he did not wish to draw attention to the showdown. Republicans do not have the votes in the House or the Senate to override the veto. (Harris, 1/8)

President Obama vetoed a bill Friday aimed at repealing his signature health care law. "This legislation would not only repeal parts of the Affordable Care Act, but would reverse the significant progress we have made in improving health care in America," the president wrote members of the House in a letter. "Republicans in the Congress have attempted to repeal or undermine the Affordable Care Act over 50 times. Rather than refighting old political battles by once again voting to repeal basic protections that provide security for the middle class, members of Congress should be working together to grow the economy, strengthen middle-class families, and create new jobs," the letter continued. (1/8)

The veto was expected. But Republicans claimed victory nonetheless, arguing that they met two goals by finally passing a repeal bill: keeping a promise to voters in an election year, and showing that they are capable of repealing the law if a Republican wins November鈥檚 presidential election. All the GOP presidential candidates support repealing the law widely referred to as 鈥淥bamacare.鈥 (Superville, 1/8)

As the next step, House Speaker Paul Ryan wants to work on a proposal to replace the health care law. 鈥淚t clears the path to repealing this law with a Republican president in 2017 and replacing it with a truly patient-centered health care system,鈥 he said. 鈥淲e will not back down from this fight to defend the sanctity of life and make quality health care coverage achievable for all Americans.鈥 (1/8)

IRS: 1.4M Households Failed To Properly Account For Subsidies From Health Law

Although the Department of Health and Human Services says it believes many of those people affected no longer have coverage through the Affordable Care Act, the complication highlights the difficulties Americans encounter with its taxes. In other health law news, the federal exchanges are falling short on getting young, healthy enrollees; the uninsured rate has ticked up; and the medical device industry is reveling in the suspension of a tax on its revenue.

About 1.4 million households that got financial help for health insurance under President Barack Obama's law failed to properly account for it on their tax returns last year, putting their subsidies at risk if they want to keep coverage. The preliminary figures were released by the IRS late Friday afternoon, a time when the government often reports unfavorable developments. A spokeswoman for the Department of Health and Human Services doubted there will be a major impact. HHS believes most of the people affected no longer have health law coverage. (Alonso-Zaldivar, 1/8)

The federal health care exchanges are so far falling short of signing up young (and presumably healthier) workers, which may portend trouble ahead for plans sold through the Affordable Care Act. When the law was created, actuaries estimated that 40 percent of the Obamacare plans would need to be sold to people between 18 to 34 years old in order to offset higher costs tied to older (and presumably sicker) workers. (Picchi, 1/8)

Two years after Obamacare went into effect, the percentage of Americans without coverage inched up in each of the second two quarters of 2015. (Braverman, 1/8)

The third open enrollment period ends Jan. 31, and the final push has begun. An estimated 80,000 people in Milwaukee County were uninsured last year. Many of them were eligible for federal subsidies to help offset the cost of health plans sold on the federal marketplace set up through the Affordable Care Act or eligible for BadgerCare Plus, one of the state's Medicaid programs. (Boulton, 1/9)

U.S. medical device manufacturers started the new year with a windfall in the form of a two-year suspension of a controversial tax on their revenue. According to the Congressional Budget Office, the suspension could save the device industry a lot of money 鈥 nearly $5 billion. (Zdechlik, 1/11)

Special Enrollment Periods Drive Up Premium Costs, Insurers Say

Meanwhile, Humana reports that it is running afoul with the individual marketplaces set up by the 2010 health law.

Eager to maximize coverage under the Affordable Care Act, the Obama administration has allowed large numbers of people to sign up for insurance after the deadlines in the last two years, destabilizing insurance markets and driving up premiums, health insurance companies say. The administration has created more than 30 鈥渟pecial enrollment鈥 categories and sent emails to millions of Americans last year urging them to see if they might be able to sign up after the annual open enrollment deadline. But, insurers and state officials said, the federal government did little to verify whether late arrivals were eligible. (Pear, 1/9)

Humana Inc. is the latest insurer to run into trouble in Obamacare鈥檚 individual health-insurance markets. The health insurer said that it probably won鈥檛 collect enough money to cover costs for some customers who bought individual plans, and will set aside what鈥檚 known as a premium deficiency reserve. The shortfall is for 2016 plans that comply with new rules under the Affordable Care Act, Louisville, Kentucky-based Humana said Friday. (Tracer, 1/8)

State Legislatures Brace For Medicaid Expansion Measures

In Alaska, early legislation includes a bill to curb the governor's ability to accept the additional federal funding. Meanwhile, in Virginia, the Medicaid expansion debate is among the issues observers expect will trigger fireworks in the state capitol.

Bills related to Medicaid and the governor's power to accept additional federal money for a budget item are included in the first batch of measures filed ahead of the upcoming legislative session. They follow Gov. Bill Walker's actions last year to expand Medicaid to provide health care coverage to more lower-income Alaskans after legislators tabled the issue for further review. ... Legislation proposed by Rep. Mike Hawker, R-Anchorage, would provide a way for lawmakers to restrict that ability with budget language. (Bohrer, 1/9)

Take one governor bent on furthering his liberal policies. Add a Republican-controlled legislature determined to stop him. It鈥檚 a recipe for partisan fireworks that will heat up Mr. Jefferson鈥檚 Capitol when the General Assembly reconvenes Wednesday. But amid expected fights over Medicaid, gun control and climate change, Virginia Gov. Terry McAuliffe (D) and Republican lawmakers are showing signs that they will try something new: compromise. ... But the session is expected to bring its share of partisan tension, as well. The No. 1 issue both parties have tangled over is Medicaid expansion. For the third straight year, McAuliffe called on lawmakers to cover 400,000 uninsured Virginians under the Affordable Care Act. ... This time [McAuliffe is] trying something new. (Portnoy, 1/9)

Administration News

In State Of The Union, Obama To Abandon Sweeping Policy Proposals For Thematic Approach

Recognizing the futility of sweeping changes during a sharply partisan election year, the president will use the speech as a way to campaign for those on the ballot in 2016. 鈥淟ast year, he spoke to Congress,鈥 said Jennifer Psaki, the White House communications director. 鈥淭his year, he鈥檒l be speaking more to the American public.鈥

For the final time, President Obama will mount the rostrum in the House chamber on Tuesday to deliver a State of the Union address. But this time, aides said, he will not bring with him a long list of proposals that will languish in Congress. Instead, Mr. Obama plans a thematic message that effectively will be as much a campaign agenda as a governing document. ... Among the ideas being discussed [as a centerpiece for the speech] was a new 鈥渕oon shot鈥 to cure cancer, sought by Vice President Joseph R. Biden Jr., whose son Beau died of brain cancer last year. Mr. Biden at one point hoped to include a major new initiative in the State of the Union, but it has taken time to sort through the options and create a plan, so while it will be referred to in the speech, the vice president will wait to make a major rollout in the next few weeks. (Baker, 1/10)

No doubt, Obama had numerous high-profile victories in 2015. He got Republicans in Congress to go along with more spending, killed the proposed Keystone XL pipeline, and his health care law lives on despite Republican-led efforts to repeal it. He also secured international agreements designed to curb global warming and stop Iran from getting a nuclear weapon. But efforts that required congressional cooperation often proved DOA. (Freking, 1/11)

Women鈥檚 Health

Abortion Battle Takes Center Stage As N.C. Ultrasound Law Goes Into Effect

The legislation requires doctors who provide an abortion after the 16th week of pregnancy to also provide an ultrasound of the fetus to state officials, a provision that has already been implemented in Louisiana and Oklahoma. In other news, Planned Parenthood Founder Margaret Sanger's grandson says he sees the same reproductive rights battles that his grandmother fought still playing out 100 years later.

A state law requiring that doctors who perform an abortion after the 16th week of pregnancy supply an ultrasound to state officials has sparked a new and bitter front in the war over abortion here, with stakes that are both personal and political. Supporters say the purpose of the law is to verify that doctors and clinics are complying with state law, which outlaws abortions after 20 weeks but with an exception made for medical emergencies. Critics say the purpose is to intimidate and provide hurdles to women and doctors. (Fausset, 1/10)

Outside the crumbling Brooklyn building where the first U.S. birth control clinic opened 100 years ago, Alexander Sanger reflected on the move that landed his grandmother in jail and fueled a controversy over women's reproductive rights that has raged ever since. "This is where it all started," said the grandson of Planned Parenthood founder Margaret Sanger in his first visit to the Brownsville, Brooklyn, site where she started her clinic in 1916. (Goldberg, 12/8)

Quality

U.S. May End Program That Entices Cuban Doctors, Nurses Into Defecting While Abroad

The gesture would aim to improve relations with Cuba, which says the "reprehensible" practice's goal is to "deprive Cuba and many other countries of vital human resources." In other health care professional news, hospitalists in Oregon unionize after outsourcing is brought to their medical center.

The U.S. government is considering putting an end to a program that encourages Cuban doctors and nurses on overseas assignments to defect, a senior aide to President Barack Obama said, in a gesture emblematic of improving U.S.-Cuban relations. The Cuban Medical Professional Parole Program, which started under President George W. Bush in 2006, targets one of Cuba's proudest achievements: sending doctors, nurses and other medical professionals abroad, either on missions of mercy or to raise cash for the Communist government. (Mason and Trotta, 1/8)

The outsourcing of hospitalists became relatively common in the last decade, driven by a combination of factors. There is the obvious hunger for efficiency gains. But there is also growing pressure on hospitals to measure quality and keep people healthy after they are discharged. This can be a complicated data collection and management challenge that many hospitals, especially smaller ones, are not set up for and that some outsourcing companies excel in. ... It was the idea that they could end up seeing more patients that prompted outrage among the hospitalists at Sacred Heart, which has two facilities in the [Springfield, Ore.] area, with a total of nearly 450 beds. ... Some Sacred Heart hospitalists left for other jobs, and the rest formed a union, one of the first of its kind in the country. (Scheiber, 1/9)

Public Health

NIH Readies For Launch Of Ambitious Precision Medicine Research Project

Meanwhile, NPR examines how opioids work on the brain and KHN details a new strategy that incorporates telenovellas to raise awareness about kidney donation among Latinos. Other headlines highlight recent developments regarding brain cancer and teen smoking.

The National Institutes of Health is preparing to recruit 1 million volunteers for one of its most significant research projects in years, one meant to develop personalized medical treatments. As it does so, officials are trying to dodge the ghosts of a similarly ambitious research initiative, one that ended with a whimper: the National Children鈥檚 Study. (Kaplan, 1/11)

They trigger the release of dopamine, which is a neurotransmitter that causes intense pleasure in parts of the brain that include the limbic system, according to Savage. It links brain areas that control and regulate emotions such as the pleasure of eating, drinking, and sex. "This is a very ancient part of the human brain that's necessary for survival," says Savage. "All drugs that people use to get high tickle this part of the brain." (Rodolico, 1/11)

Inf贸rmate, a new bilingual website, [is] dedicated to using culturally familiar methods to educate Latinos about options for living kidney donation. The marketing strategy is intended to address a growing need among Latinos. Kidney failure in this population has increased by more than 70 percent since 2000, and more than 23,000 Latinos are on the kidney transplant list, according to federal statistics. But too often, researchers and doctors said, families are not aware of the transplant regimen involving a live donor and have unfounded fears about what could happen if they volunteer to offer a kidney to a relative or friend. (Kritz, 1/11)

In the 1990s, an Israeli biophysicist wondered whether cells that were in the process of dividing might be vulnerable to damage by electromagnetic energy. If so, then maybe electric fields could be used to disrupt the growth of cells that divide relentlessly and uncontrollably - otherwise known as cancer. (McCullough, 1/10)

Even though fewer U.S. teens are smoking, secondhand smoke remains a big problem for them, a government study found. Nearly half of nonsmoking kids in middle school and high school encountered secondhand tobacco smoke in 2013, and rates were even higher among smokers. (Tanner, 1/11)

Researchers Say Exercise Can Help Patients With Cancer, Diabetes

Although many oncologists and patients themselves may think rest is best for battling cancer, new analysis suggests that those who incorporated exercise into their care plan reported significantly better quality of life, as well as improvements with peak oxygen consumption, fatigue and length of hospital stay. Another study finds that patients with diabetes should be given specific instructions -- or "prescriptions" -- regarding exercise.

Exercise may help improve quality of life for some cancer patients during treatment as well as afterward, a new analysis of previous research suggests. Even though physical activity isn鈥檛 routinely prescribed as part of usual care for cancer patients, the analysis found a variety of activities such as walking, swimming, cycling and strength or stability training associated with better physical, mental, emotional and social functioning. (Rapaport, 12/8)

Patients with type 2 diabetes should be given exercise 鈥減rescriptions鈥 that specify the type, duration, intensity and frequency of workouts, adapted to the individual, according to a new review. Although exercise improves blood sugar control, insulin sensitivity, blood pressure and cholesterol levels, most people with diabetes do not engage in regular exercise, the authors write. (Doyle, 12/8)

State Watch

State Highlights: California Becomes Ground Zero For Insurance Mega-Merger Scrutiny; Kansas Insurer To End Prior Authorization For Mental Illness Care

News outlets report on health care developments in California, Kansas, Wyoming, Texas, Washington, Chicago, West Virginia, Texas and Ohio.

California is becoming a battleground state in the fight over health insurance mega-mergers. Consumer advocates are putting pressure on regulators in California and a dozen other key states to scrutinize the deals amid concerns that consumers will be left with fewer choices and higher costs. There's a lot at stake for families and employers if the deals go through and leave three health insurers in control of nearly half of the U.S. commercial insurance market. (Terhune, 1/11)

Blue Cross and Blue Shield of Kansas won鈥檛 require customers who need mental health services to get prior authorization going forward, but it can recoup payments from providers if their treatment is significantly different from that of their peers. Mary Beth Chambers, spokeswoman for Blue Cross and Blue Shield of Kansas, said the change brings the insurer鈥檚 mental health policies in line with its policies for other types of medical care and with mental health parity laws. Eliminating prior authorization also will reduce paperwork for providers, she said. (Hart, 1/8)

Across the country, the first professional responder someone in a mental health crisis sees is often law enforcement. That鈥檚 especially the case in Wyoming, where the suicide rate is double the national average and lacks the mental health resources of more urban areas. (Bryan, 1/8)

As of New Years Day, licensed gun owners in Texas have been allowed to openly carry firearms into restaurants, shops and zoos. Add a new place to the gun-friendly list: state mental health hospitals. (Jervis, 1/8)

A new push is on by Washington lawmakers to raise the legal age to buy tobacco from 18 to 21. An effort to raise it last year didn鈥檛 gain traction despite publicized support from state Attorney General Bob Ferguson, but lawmakers filed a new bill in advance of the legislative session that begins Monday. (Orenstein, 1/8)

State Rep. Ed Soliday's big proposed legislation for the year is intended to raise money for roads, but a portion of it has health advocates cheering and smokers concerned. Soliday's proposed bill is aimed at raising more revenue to take care of roads and transportation at the state level. Part of that includes diverting all of the gasoline sales tax revenue from the general fund to roads. (Schultz, 1/8)

West Virginia's attorney general has accused one of the nation's largest pharmaceutical drug wholesalers of flooding the state with tens of millions of prescription pills in violation of state law. Attorney General Patrick Morrisey on Friday announced a lawsuit against San Francisco-based McKesson Corp. Among other things, the lawsuit alleges violations of state consumer protection laws and the Uniform Controlled Substances Act. (Raby, 1/8)

Urgent care centers, such as the San Antonio-based Texas MedClinic chain, usually are staffed by physicians trained in emergency medicine and provide walk-in care seven days a week, sometimes 24 hours a day. They often have their own labs and X-ray equipment, accept a range of private insurance and are very visibly located along major highways and, increasingly, in neighborhood shopping centers. (Marini, 1/10)

Enrollment in health-care sharing ministries recently shot past half a million people, up from about 200,000 three years ago. The trend has been partly fueled by the Affordable Care Act, ministry officials say. (Sutherly, 1/11)

Editorials And Opinions

Viewpoint: GOP's Repeal Bill Could Be A Test-Run; Another Side Effect Of High Deductibles

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

On January 8, 2016, President Obama to the surprise of no one vetoed HR 3762, the budget reconciliation act that sought to repeal the Affordable Care Act. ... It was clear from the outset that the legislation would be vetoed. The Republicans in the Senate, however, got a chance to vote for repeal. They also got, for future reference, an opportunity to see what provisions of a potential repeal bill the Senate parliamentarian would approve as appropriate for a reconciliation bill. If the Republicans succeed in electing a president this knowledge may prove quite valuable. What the Republicans did not do was put forward a strategy for replacing the ACA had their repeal strategy succeeded. (Timothy Jost, 1/9)

Republican and Democratic governors in several states that have refused to expand their Medicaid programs are now seeking to do so, but will need approval from Republican-dominated legislatures. Even if they are not moved by humanitarian concerns to improve health care for their poorest citizens, recalcitrant legislators should at least see the folly of rejecting extremely generous matching funds. The federal government will pay 100 percent of the cost for newly eligible enrollees in 2016 and 95 percent in 2017, phasing down to 90 percent in 2020 and subsequent years. (1/11)

A decade ago, most middle-class Americans felt pretty good about their health insurance, and politically supported extending coverage to the uninsured. Now, more than a quarter of those folks are paying $1,000 or more before their coverage kicks in. They aren't likely to be politically supportive of calls to increase subsidies to people in exchange-based plans to cover their out-of-pocket costs. High-deductible plans are not an effective means of promoting high-quality healthcare. When people have more skin in the game, they cut back on utilization. But studies show they are just as likely to cut back on necessary care as on unnecessary or overly expensive drugs, tests and procedures. Price transparency still isn't a major factor in the marketplace. (Merrill Goozner, 1/9)

The famed pediatric neurosurgeon said not a word in his campaign speech [in Cedar Rapids, Iowa] Thursday about what he would do on healthcare policy if he's elected president. In contrast, the former president had a lot to say during his talk the same day in this eastern Iowa city about what his wife would do on healthcare if she's elected to the White House. Members of both their audiences said they wanted to hear more from the candidates on healthcare as they troop through Iowa in the lead-up to the Feb. 1 Iowa presidential caucuses. (Harris Meyer, 1/8)

You could be forgiven for not hearing about Liberty Mutual v. Gobeille, a case on the Supreme Court鈥檚 docket this term. ... Gobeille has nothing to do with some of the more exciting issues of the day. But what the court decides in Gobeille could spell the end of state efforts to inject long-overdue price transparency in health care pricing, potentially affecting millions of Americans. The legal question in Gobeille is simple: does the Employment Retirement Income Security Act (ERISA) pre-empt state efforts on health care transparency. (Yevgeniy Feyman, 1/11)

This year, more physicians will be doing advanced care planning. If you have Medicare, your doctor will now be reimbursed for an appointment to discuss the type of life you want when ill. Palliative care may be part of that conversation. This is medical care that aims to relieve patients of the symptoms, pain, and stresses of advanced illness -- whatever the diagnosis. The goal is to improve quality of life and relieve suffering for both patient and family. Palliative care is appropriate at any age and at any stage in an advanced illness, and curative treatment doesn't have to stop. (Perry Farmer and Barbara Ebling, 1/11)

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