Morning Briefing
Summaries of health policy coverage from major news organizations
From 麻豆女优 Health News - Latest Stories:
麻豆女优 Health News Original Stories
Check The Fine Print: Some Work-Based Health Plans Exclude Outpatient Surgeries
This new generation of so-called 鈥渟kinny plans鈥 can save employers money, but it鈥檚 not yet clear if they will meet regulatory scrutiny.
Summaries Of The News:
Campaign 2016
Clinton Reminds Voters She Wanted Universal Health Care First
After weeks of criticizing Bernie Sanders鈥檚 plan for a single-payer 鈥淢edicare for all鈥 health care system as budget busting and unrealistic, Hillary Clinton over the past few days has a new message for voters: Universal health care was her idea first. 鈥淣ow, before it was called Obamacare, it was called Hillarycare, as some of you might remember,鈥 Mrs. Clinton said at a town-hall-style event in Clinton, Iowa, on Saturday. 鈥淲e share the same goal, universal health care for every single American,鈥 Mrs. Clinton said of her rival Mr. Sanders. 鈥淏ut we have a real difference about how to get there.鈥 (Chozik,1/23)
Hillary Clinton is taking increasing credit for Obamacare, arguing that the 1993 health care overhaul effort she spearheaded was the foundation for President Barack Obama's plan. 鈥淚t was called Hillarycare before it was called Obamacare,鈥 the Democratic presidential candidate said in Vinton, Iowa, on Thursday, referring to her plan's derisive nickname. 鈥淚 don't want to start over again, I don't want to rip up this accomplishment and begin this contentious debate all over again.鈥 (Kapur, 1/22)
Bernie Sanders鈥 plan to deliver 鈥淢edicare for all鈥 may be a good deal for many Americans, but it might be bad for working seniors already enrolled in the government health plan. Under his plan, the nation鈥檚 8.5 million seniors over the age of 65 and already eligible for Medicare would get hit with tax increases. With more of the nation鈥檚 baby boom generation working into traditional retirement years, the concern is that the costs to seniors are higher than Sanders' plan suggests. (Przybyla, 1/24)
A week after Hillary Clinton accused Bernie Sanders of jeopardizing the Democrats鈥 hard-fought Obamacare victory by reopening the debate over health insurance, her chief competitor for the party鈥檚 2016 presidential nomination is rolling out a new strategy for selling his "Medicare for All" plan. Asking audience members at his rallies to shout out their own deductibles鈥攖he amount they have to pay out-of-pocket each year before their medical insurance kicks in. (John, 1/23)
Bernie Sanders has finally outlined how he'd pay for his nearly $14 trillion Medicare-for-all plan, but lots of unanswered questions remain. (Luhby, 1/25)
Meanwhile, Sanders defends his commitment to Planned Parenthood聽鈥
Democratic presidential candidate Bernie Sanders on Friday proclaimed his commitment to abortion rights and to increasing funding for women鈥檚 health care, days after a tussle with rival Hillary Clinton鈥檚 campaign over whether a prominent women鈥檚 health care provider was part of the Democratic 鈥渆stablishment鈥 he is challenging. 鈥淚 am a very strong supporter of Planned Parenthood,鈥 the Vermont senator said at a rally at a high school on Friday, the 43rd anniversary of the Roe v. Wade Supreme Court decision that established a legal right to abortion. 鈥淚 have a lifetime voting record of 100%.鈥 (Haddon, 1/22)
The race between Hillary Clinton and Senator Bernie Sanders is not just about the White House anymore. It has intensified into an epochal battle over their vastly different visions for the Democratic Party. Mr. Sanders, a New Deal-style liberal from Vermont, last week became the party鈥檚 first top-tier candidate since the 1980s to propose broad-based tax increases. He argues that only muscular government action 鈥 Wall Street regulations, public works jobs, Medicare for all 鈥 will topple America鈥檚 鈥渞igged鈥 economy. Mrs. Clinton, a mainstream Democrat, has started contrasting herself with Mr. Sanders by championing a 鈥渟ensible, achievable agenda鈥 and promising to build on President Obama鈥檚 legacy in health care, the economy and national security. (Healy, 1/24)
And Republican presidential candidate Ted Cruz's campaign corrects聽his claims about losing his health care insurance 鈥
Ted Cruz has health insurance, and he had it all along, his campaign said Friday night, reversing what the presidential candidate said a day earlier. Mr. Cruz told a Manchester, N.H., audience on Thursday that he was currently uninsured 鈥 which he said infuriated his wife 鈥揳fter Blue Cross and Blue Shield of Texas canceled many individual policies, including his. As a result, Mr. Cruz said he was now looking to buy a new plan at sharply higher premiums, a turn of events he attributed to the Affordable Care Act, also called Obamacare. Mr. Cruz has been a harsh critic of the health law. (Radnofsky, 1/22)
One day after Ted Cruz told college students in New Hampshire that he had no health insurance because President Barack Obama's health care law caused the cancellation of his coverage, the Republican presidential candidate's campaign walked back that assertion late Friday. Contrary to what Cruz, a top contender for the GOP nomination, said on Thursday鈥"I don't have health care right now"鈥攊t turns out the U.S. senator from Texas and his family appear to be insured after all. (Kapur, 1/23)
Health Law
As Enrollment Deadline Nears, Obama Praises Health Law Successes In Radio Address
President Obama on Saturday touted the successes of his signature healthcare law, just days before the deadline for enrolling in 2016 ObamaCare coverage ends on Jan. 31. 鈥淭his is healthcare in America today,鈥 he said in his weekly address. 鈥淸It is] affordable, portable security for you and your loved ones. It鈥檚 making a difference for millions of Americans every day [and] it is only going to get better.鈥 Obama boasted that ObamaCare is expanding healthcare options for everyday Americans. (Hensch, 1/23)
The president ticked off several metrics on America's current health insurance coverage rates, including the nearly 18 million individuals that have gained coverage since the ACA took effect. "For the first time ever, more than 90 percent of Americans are covered," the president said. "We've done all this while cutting our deficits and keeping health care inflation to its lowest levels in 50 years. And we've begun filling the gaps in employer-based care so that when we change jobs, lose a job, go back to school or start that new business, we can still get coverage." (Flores, 1/23)
Last year regulators blocked companies with millions of lower-wage workers from claiming that coverage with no inpatient hospital benefits met Obamacare鈥檚 strictest standard for large employers. Now that those so-called 鈥渟kinny plans鈥 aren鈥檛 allowed, insurance administrators and many cost-conscious employers are purporting to meet the rules with a new version that excludes another major category: outpatient surgery. The new plans may not survive regulatory scrutiny any more than the old ones did, some experts believe. (Hancock, 1/25)
With just days left to sign up for health coverage at healthcare.gov, a question hangs over Ohio: Beyond its suburban counties, will the state warm up to the government-run marketplace? ... Ohio's overall interest in marketplace coverage has been tepid. A recent Urban Institute analysis of the marketplace's first two years found that the state's enrollment rate 鈥 20 percent of the eligible population 鈥 was eighth lowest in the nation. One reason is that premiums for plans sold through the marketplace in Ohio have been higher than those in other states, said Trey Daly, Ohio director for Enroll America. Meanwhile, the tax credits that can help people with lower incomes pay for coverage have been smaller, on average, than in other states, he said.(Sutherly, 1/24)
The number of people who have enrolled for health insurance through the Affordable Care Act stands at 97,909 with less than 11 days before the final deadline to get 2016 coverage. Jan. 31 is the deadline for people to sign up at HealthCare.gov for coverage. (1/22)
The House has postponed votes this coming week 鈥 including one on overriding President Barack Obama鈥檚 health care veto 鈥 because of the snowstorm. Senators plan to begin work Wednesday evening, extending a delay imposed even before the storm hit. (1/24)
Utah Lawmakers May Weigh New Options For Expanding Medicaid
Despite years of discussing the issue without resolution, Utah lawmakers will again take on Medicaid expansion and various plans to implement it for the thousands of Utahns who remain uncovered by health insurance. And, while some lawmakers are taking approaches that have been tried before, others are trying new things 鈥 an indication of a potential desire to bring health care benefits closer to Utahns who can't afford them. (Leonard, 1/24)
Last week, GPB鈥檚 鈥淭he Lawmakers鈥 had Senate Majority Leader Bill Cowsert, R-Athens, and state Rep. Stacey Evans, D-Smyrna, to talk about medical care in Georgia. But the show was stolen by state Sen. Fran Millar, R-Dunwoody, who predicted that, no matter what Republican protests you hear elsewhere, Medicaid expansion under Obamacare will ultimately happen. (Galloway, 1/24)
Marketplace
'Widespread And Systemic Failures' Cited In Cigna Medicare Advantage Suspension
Cigna Corp. said Friday that enrollment into its Medicare Advantage and prescription-drug plans has been halted by the government, posing a challenge to the insurer as it aims to wind up its acquisition by Anthem Inc. In a letter to Cigna, the Centers for Medicare and Medicaid Services said it imposed the sanctions because of problems with the insurer鈥檚 coverage-appeals process, among other issues, and the agency cited a 鈥渓ongstanding history of noncompliance鈥 with requirements. Connecticut-based Cigna was also blocked as of 11:59 p.m. EST Thursday from marketing its Medicare plans. (Wilde Mathews, 1/22)
The U.S. government has suspended new enrollment in Cigna Corp's Medicare Advantage health insurance and prescription drug plans, saying Cigna had "widespread and systemic failures" that prevented patients from accessing medical services. The government said Cigna did not handle complaints and grievances properly from patients who had been denied coverage for health benefits or drugs, according to a Jan. 21 letter from its regulator, the Centers for Medicare and Medicaid. (Humer, 1/22)
U.S. regulators have temporarily banned health insurer Cigna from offering certain Medicare plans to new patients after a probe uncovered issues with current offerings. ... The sanctions, which took effect at the end of the day Thursday, do not affect patients who are already enrolled. CMS said could not provide an estimate for how many patients were affected. (Bomey, 1/22)
In other news on Medicare Advantage, a new study looks at CMS's cost predictions聽鈥
The Centers for Medicare and Medicaid Services under-predicts costs for Medicare Advantage patients with multiple chronic illnesses by about $2.6 billion annually, according to a study by Avalere Health. The report, published today and funded by the lobbying group America鈥檚 Health Insurance Plans, suggested Medicare Advantage鈥檚 risk-adjustment model is to blame for the cost discrepancies. (McIntire, 1/22)
Public Health
Employers, Regulators Struggle To Navigate The Do's And Don'ts Of Wellness Programs
It may be an offer employees simply can no longer refuse. Workers increasingly are being told by their companies to undergo health screenings and enroll in wellness programs, as a way to curb insurance costs. Many employees now face stiff financial penalties 鈥 often in the form of higher premiums 鈥 if they do not have their cholesterol checked or join programs to lose weight or better manage diabetes. (Abelson, 1/24)
The scale of government neglect in the water crisis in Flint, Mich., could place the city alongside some of the most infamous environmental disasters in U.S. history, from New York鈥檚 Love Canal to the Hinkley, Calif., saga of Erin Brockovich fame. Local, state and federal officials 鈥 including the top Environmental Protection Agency administrator in the Midwest and Michigan鈥檚 Republican governor, Rick Snyder 鈥 are accused of ignoring, denying or covering up problems that left thousands of children exposed to toxic lead in their drinking water for about 18 months. (Bernstein and Dennis, 1/24)
In other public health news, WHO warns Zika is likely to spread to all but two countries in the Americas, a decade-old cancer case heads to trial and the U.S. is lagging in reducing stillbirths聽鈥
The mosquito-borne Zika virus, which is suspected of causing brain damage to babies in Brazil, is likely to spread to all countries in the Americas except for Canada and Chile, the World Health Organization said on Monday. Zika has not yet been reported in the continental United States, although a woman who fell ill with Zika in Brazil later gave birth to a brain-damaged baby in Hawaii. (Miles, 1/23)
A decade after a group of smokers from Massachusetts sued Philip Morris USA to try to force the cigarette maker to pay for lung cancer screenings, the case will finally be heard by a jury. Smokers in the class-action lawsuit allege Philip Morris manufactured a defective cigarette knowing it could have made a safer product with fewer carcinogens. They are not seeking money, but instead want to compel Philip Morris to pay for highly detailed, three-dimensional chest scans that can detect signs of early-stage lung cancer that may be too small to show up on traditional X-rays. (1/25)
Stillbirth remains largely hidden from society, and the tragic loss of a fetus late in pregnancy remains far too common. ... In the U.S., the stillbirth rate is 3 per 1,000 births, putting it 22nd among 186 countries. What's more, that rate has barely budged in 15 years, declining just 0.4 percent. That's slower progress than was seen in all but a handful of countries. In sheer numbers, that means there were 11,260 stillbirths last year in the U.S., if you use the World Health Organization's definition: fetal death after 28 weeks of pregnancy. (Hobson, 1/22)
Health IT
Consumers Want Privacy Wall Around Personal Health Info, Tech Execs Find
Consumers have willingly traded some of their personal details for access to social sites like Google or Facebook, and suffer an occasional ad as a result. But once that sharing gets too personal, as with health-care information, it could prompt people to retreat behind a wall of privacy, according to a panel of technology experts at the World Economic Forum in Davos, Switzerland. (Vynck, 1/22)
Epic makes the software your doctor and hospital may well use to track everything they know about your health, from the results of your annual physical to your cholesterol prescription to the X-ray from your emergency room visit when you sprained your ankle. If you're a patient of Aurora Health Care, for example, a nurse at any Aurora urgent care clinic can use Epic's software to retrieve your entire medical record on the spot, including what allergies you have and what conditions you've been treated for lately. (Boulton, 1/24)
State Watch
State Highlights: Rural Hospital Crisis Continues; Utahns Want More Open Talk About Health Care Plan
Southern Palmetto Hospital in Barnwell announced in a statement Tuesday that it will at least temporarily end 鈥減atient operations.鈥 In other words, it will not be treating patients. It鈥檚 the third rural hospital in South Carolina to close since 2011, according to a report by South Carolina Radio Network. (Miller, 1/24)
Want to know how your legislator voted on Utah Access Plus, the proposal to expand health care to about 125,000 of Utah's poorest residents? Don't bother searching. There was never an official recorded vote on the plan. In fact, the votes that doomed the health care bill were all taken in secret 鈥 with Republican House members voting in a closed-door meeting and GOP senators casting private votes after confidential discussions. It's not the kind of lawmaking that Utah voters approve of, according to a new poll for The Salt Lake Tribune and The Hinckley Institute of Politics at the University of Utah. The survey found that 91 percent of Utahns want legislative meetings to be held out in the open. Republicans control the Senate by a 24-5 margin and the House, 63-12. Despite the public's preference and protests from Utah media outlets, don't expect much to change in the legislative session beginning Monday. (Gehrke, 1/25)
The Democratic presidential candidates sparred vigorously over healthcare in their most recent debate. Front-runners Bernie Sanders and Hillary Clinton dominated the exchange, so talk of Maryland's singular hospital payment reform ended almost as quickly as it started. ... So what is happening in Maryland? And is it a good idea for it to be a national model? It could be done in any state in the union,鈥 said Dr. Robert Berenson, an Urban Institute senior fellow and former CMS official. ... But that would take significant political will by states to more actively regulate hospitals, he said, which all states but Maryland abandoned. Maryland is also still an experiment, with encouraging early numbers, but no guarantee of success. (Evans, 1/23)
CenterLight Health System Inc, a New York long-term managed care provider, agreed on Thursday to pay $47 million to settle allegations that it enrolled ineligible Medicaid beneficiaries. The enrollees at issue were referred by CenterLight to adult day care centers, which provided services that did not qualify for reimbursement, state and federal authorities said. (Freifeld, 1/22)
A federal district judge must again consider a long-running dispute over a West Virginia chemical company's move to force retirees to pay for their healthcare benefits or lose them, a U.S. appeals court ruled on Thursday. (Iafolla, 1/22)
Virginia Gov. Terry McAuliffe鈥檚 administration is seeking an extra $110鈥塵illion over the next three years to provide more services to residents with severe disabilities to comply with a federal court settlement. The money would intensify the state鈥檚 efforts to move people off a waiting list for services that currently has about 10,100 names. It would fund 855 Medicaid waivers for residents who do not have them and pay for an overhaul of how the state awards those waivers to better prioritize services for people in immediate need of aid. (Olivo, 1/23)
Massachusetts life sciences executives are considering what their industry should be doing to address the nation's opioid abuse epidemic. That topic will be the focus of a panel discussion Wednesday morning at the Massachusetts Biotechnology Council's annual Policy Leadership Breakfast. (1/24)
The Kansas Court of Appeals refused Friday to allow the state鈥檚 first-in-the-nation ban on a common second-trimester abortion method to take effect, saying in a split decision that the Kansas Constitution protects abortion rights independent of the U.S. Constitution. The 7-7 ruling was released on the anniversary of the U.S. Supreme Court鈥檚 Roe v. Wade decision. Tie votes from the appeals court uphold the lower-court ruling being appealed. (1/22)
Four years ago, Dr. Annie Brewster had a vision. Brewster, a Boston internist, who was diagnosed with multiple sclerosis in 2001, had become frustrated that a crucial element of medicine 鈥 the human connection between patients and doctors 鈥 seemed to be lost in the modern era of 15-minute appointments and overly burdensome record-keeping. As a patient and a doctor, Brewster yearned for a therapeutic arena in which patients could tell their full health stories and feel they were actually heard, not rushed out the door; and where doctors, as well, could share a little more with patients. (Zimmerman, 1/22)
New York's Department of Health is sponsoring research on the use of a pharmaceutical-grade medical cannabis drug to treat children with severe epilepsy. The department announced the studies Wednesday. They'll be open to 100 children and young adults whose epilepsy has resisted other treatments. (1/24)
Editorials And Opinions
Viewpoints: Health Law Unhappiness?; Single-Payer And The 'Continental Divide'
While America鈥檚 health-care system has long needed reform, President Obama unfortunately made many parts of it worse. His Affordable Care Act is based on more federal spending, regulation and coercion鈥攁nd Americans are now experiencing the many unhappy consequences. (Lanhee J. Chen and James C. Capretta, 1/24)
Bernie Sanders restarted the debate about single-payer health care on Sunday by proposing "Medicare for all." Leonid Bershidsky pointed out that in Europe, his idea would hardly be radical. But Megan McArdle finds the Sanders plan implausible in the U.S. Bloomberg View invited them to debate whether American health care could imitate Europe's. (Megan McArdle & Leonid Bershidsky, 1/22)
Hillary Clinton is wrong when she says that Medicare for all is not achievable. In fact, if she and her husband had embraced the concept in 1993, we would be nearly there today. ... In 1993, the electorate wanted better health care. The newly elected President Bill Clinton put Hillary Clinton in charge of a task force to develop a proposal. They created a Rube Goldberg machine, easily attacked by the health care industry because the proposal was so hard to understand. If instead, the Clinton administration had further built on the extremely successful and popular Medicare program, then nearly three decades old, they would likely have been successful. (Nancy Altman, 1/24)
If the question is about health care, Sen. Bernie Sanders is the only presidential candidate able to give a short answer: Medicare for all. In a world of health-savings accounts, interstate insurance sales, exchanges, silver or gold plans and accountable health care organizations, he dusts off a proposal from the 1980s: universal coverage by a single payer -- the federal government. (H. Gilbert Welch, 1/24)
It鈥檚 a sad indication of how deep some ideological ruts have become that opponents had tallied the votes against Sen. John McCollister鈥檚 new health care plan before they even knew what it was. Just the mention of the Affordable Care Act apparently was enough for at least 18 state senators to, in figurative terms, cover their ears and singing la-la-la-la. Nebraskans deserve better than that, especially the working poor who McCollister, a Republican and former director of the conservative Platte Institute, is trying to help. (1/19)
Congress has historically treated drug abuse as a malady afflicting mostly poor, minority communities, best dealt with by locking people up for long periods of time. The epidemic of drug overdose deaths currently ravaging white populations in cities and towns across the country has altered this line of thinking, and forced lawmakers to acknowledge that addiction is a problem that knows no racial barriers and can be best addressed with treatment. This realization is driving bipartisan support in Washington for saner, less punitive drug policies, some of which Congress had steadfastly resisted for decades. (1/25)
Forty-three years ago this week, the Supreme Court recognized that the Constitution protects a woman鈥檚 right to decide to have an abortion. But since the Court decided Roe v. Wade in 1973, states have passed more than 1,000 restrictions that make it much harder for a woman who has decided to have an abortion to actually get one. While many of these restrictions mask themselves as being necessary for or beneficial to patient care, the real agenda of some politicians is to ban abortion outright. Since they can鈥檛, they are using restrictive laws to put abortion out of reach. In 2015 alone, 57 new restrictions on abortion access were signed into law across the nation. (Derek Selznick, 1/22)
We march because we must. We march for the voiceless, the defenseless, those 58 million preborn children who have lost their lives to the violence of abortion as well as their mothers who have paid a heavy price in terms of increased risks of depression, suicide, drug and alcohol abuse, not to mention an array of physical complications, even death. (Schu Montgomery, 1/22)
Mark Twain once said, 鈥淕iving up smoking is the easiest thing in the world. I know because I鈥檝e done it thousands of times.鈥 Perhaps you have, too. But if you鈥檙e one of the seven in 10 smokers who want to quit and make it stick, you might just find success by talking with your physician about the best route to take. Studies have shown that when smokers work with their physician, they are more likely to be successful. (David J. Bensema, 1/21)