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
Advocates Allege Discrimination In California鈥檚 Medi-Cal Program
A civil rights complaint says low payment for doctors results in unequal care for Latinos.
Despite Hopes Of Health Law Advocates, 鈥楳ulti-State鈥 Health Plans Unavailable In Many States
The authors of the law mandated the program to try to generate more competition in areas where few plans were available. But the effort has stalled.
Last Chances Approach To Sign Up For 2016 Obamacare Coverage
With a two-day extension, December 17th is now the last chance to sign up for Obamacare health insurance coverage聽that starts Jan. 1聽through the federal exchange. Open enrollment for the plans continues through the end of January, however.
Summaries Of The News:
Health Law
Enrollment Deadline Pushed Back Due To 'Unprecedented' Demand
Kevin Counihan, CEO of HealthCare.gov, made the announcement Tuesday night, citing "unprecedented" consumer demand. (12/15)
The additional two days from the previous Dec. 15 deadline will allow consumers in the 38 states that use Healthcare.gov to sign up for plans that take effect Jan. 1. The Centers for Medicare & Medicaid Services granted similar extensions during the last two open enrollments. (O'Donnell, 12/15)
Federal officials say the previous few days have been the busiest ever at the Obamacare website, with hundreds of thousands selecting health plans. But it's too early to say if the sign-up surge indicates that the administration will meet its modest enrollment goals for 2016. (Pradhan, 12/15)
Covered California officials announced that due to a surge in demand for health insurance through the state marketplace, it has extended the enrollment deadline by two days for coverage that begins Jan. 1. Officials said the Covered California Service Center will be open from 8 a.m. to 8 p.m. Wednesday and Thursday. (Locke, 12/15)
Kaiser Health News staff writer Julie Rovner joins Here & Now鈥檚 Jeremy Hobson to explain the enrollment deadline, what the penalty is for not having health insurance in 2016 and also answers other questions about coverage. (Rovner, 12/15)
Tuesday was a big deadline for signing up for health insurance coverage. But one of the key sign-up locations wasn鈥檛 bustling when Bhargav Patel stopped by in the morning to make sure his son would be able to keep his insurance. (Levin Becker, 12/15)
Arkansas Panel Set To Finalize Recommendations Regarding Medicaid Expansion Plan
A legislative task force Tuesday held the first of what are scheduled to be three consecutive days of meetings to finalize the recommendations it will make for the future of Medicaid in Arkansas. Most of the discussion during Tuesday鈥檚 meeting of the Health Reform Legislative Task Force was not about the private option, Arkansas鈥 version of Medicaid expansion, but about ways to achieve cost savings across the entire Medicaid system. (Lyon, 12/15)
A legislative task force plans to make recommendations today on changes to the state's Medicaid program, including changes to the private option and whether to hire managed-care companies to provide coverage for recipients with expensive medical needs. Under the private option, the state uses Medicaid funds to buy coverage on the federally run insurance exchange for low-income adults. (Davis, 12/16)
Capitol Watch
Congress Reaches Year-End Spending, Tax Deals
House Speaker Paul Ryan unveiled a massive tax and spending package Tuesday night, arguing that the GOP didn't win every fight, but they kept many of their policy preferences in place for the next 10 months. In a closed-door meeting with fellow Republicans, Ryan touted a pause in Obamacare's "Cadillac tax," the lifting of a longstanding oil-export ban and preservation of several other policy preferences in the year-end deal. It will get a vote later this week. (Sherman, Bresnahan and French, 12/15)
The sweeping agreement that came after weeks of bipartisan negotiations is the broadest tax and spending deal since the January 2013 鈥渇iscal cliff鈥 agreement, and both parties will be able to claim policy victories while bemoaning what also made it in or was left out. (Snell and DeBonis, 12/15)
The $1.15 trillion spending bill to fund fiscal year 2016 was completed and released around 1:30 a.m. on Wednesday, following weeks of negotiations on Capitol Hill. Late Tuesday night, lawmakers also reached a deal on legislation that would revive and extend dozens of lapsed and expiring tax breaks. (Peterson and Rubin, 12/16)
U.S. lawmakers unveiled a tax-cut package late Tuesday night that would revive dozens of expired breaks and lock many of them into law permanently. ... The so-called Cadillac tax on high-cost employer-sponsored health insurance would start in 2020 instead of 2018, providing a win for labor unions and large companies that have been fighting it. That measure is attached to the spending bill. A tax on health insurance may also get suspended. (Rubin, 12/16)
The White House knew it was in trouble on the afternoon of Dec. 3, when the Senate overwhelmingly voted to repeal the so-called Cadillac tax in a symbolic, bipartisan vote. Ninety out of 100 senators, including scores of Democrats, backed scrapping the Cadillac tax, a key pillar of the Affordable Care Act. Beginning in 2018, the excise tax on high cost health plans was supposed to raise money to help pay for covering people under Obamacare. It was also designed to tamp down health spending in the future. (Cook, 12/15)
9/11 Health Bill Included In Spending Deal
After tirelessly lobbying Congress since late summer, the first responders who spent months working at Ground Zero following the terrorist attacks on Sept. 11, 2001, are set to finally receive lifetime medical care for the illnesses attributable to their time on "the pile." (Russert, Moe and Thorp, 12/15)
Congress appears ready to reauthorize the James Zadroga 9/11 Health and Compensation Act, the federal legislation that provides benefits to 9/11 victims and first responders. The measure was included in the newest spending bill, which has been fiercely negotiated over the past several days. The bill could be voted on as early as Thursday. (Goldberg, 12/15)
The National Institutes of Health will get a $2 billion funding increase in the federal spending bill released early Wednesday, a big boost that could turn around the agency鈥檚 fortunes after years of stagnant budgets. It鈥檚 the first time the NIH budget would get such a large raise in more than 12 years 鈥 assuming the spending bill can get enough votes to pass Congress. And it comes after a year of growing momentum in which powerful Republicans and Democrats convinced their colleagues that medical science is ready to make good use of extra money. (Nather and Scott, 12/16)
In Price-Gouging Investigation, Oversight Committee Calls For Generic-Drug Information From FDA
Republicans on the House Oversight and Government Reform Committee sent a letter to the Food and Drug Administration on Tuesday requesting documents and information on the agency鈥檚 process for reviewing generic drug applications. The lawmakers called the request part of its investigation into high prescription drug prices. The letter, signed by Chairman Jason Chaffetz, R-Utah, and 12 other Republicans, said the committee questions the efficiency of the FDA鈥檚 approval process for generic drugs, which has slowed since the agency began collecting user fees from generic drugmakers in 2013. The committee suggested that if this process were faster, it could help spur competition and drive down prices. (Siddons, 12/15)
The ranking Democrat on the House Oversight and Government Reform Committee is turning up the heat on beleaguered Valeant Pharmaceuticals, as the committee continues investigating soaring drug prices. Cummings is now sending Valeant鈥檚 CEO a letter asking for the witnesses and documents by Jan. 8, ahead of a committee hearing. (12/16)
Marketplace
Valeant Pharmaceuticals Strikes Distribution Deal With Walgreens
Valeant Pharmaceuticals International has agreed to distribute many of its drugs through Walgreens stores in a new way and, in some cases, for lower prices, the companies announced on Tuesday. The agreement appeared to be part of Valeant鈥檚 strategy to replace its reliance on Philidor Rx Services. Philidor, a mail-order pharmacy, had played a big role in keeping insurers and corner drugstores from substituting less expensive alternatives for Valeant鈥檚 high-priced dermatology drugs. (Pollack, 12/15)
Valeant Pharmaceuticals regained some credibility with upset investors thanks to its announcement Tuesday of a new distribution deal with Walgreens and plans to line up more pharmacies to sell its products after a scandal forced it to cut ties with a key distributor, Philidor. (Johnson and Murphy, 12/15)
Stung by criticism that it jacked up the price of lifesaving medicines, Valeant Pharmaceuticals said Tuesday it will lower some prices though an agreement with Deerfield-based Walgreens, the nation's largest pharmacy retailer. Valeant said its "fulfillment agreement" will cut prices by 10 percent on all skin and eye medicines, and by more than 50 percent on some other branded drugs that that have generics available. The lower prices will be phased in over the next six to nine months, said Valeant, based in Laval, Quebec. (Russell, 12/15)
Valeant shares surged 12 percent to $105.76 at 11:25 a.m. in New York. They climbed as much as $109.25 earlier, the highest price since Oct. 29. The company has been under pressure over how it prices drugs and its relationship with mail-order pharmacies such as Philidor Rx Services, which specialized in helping doctors and patients get access to Valeant drugs even when insurers declined to cover them. The stock has plummeted from an all-time high of $262.52 on Aug. 5. (Torsoli and Chen, 12/15)
Valeant Pharmaceuticals International Inc. on Wednesday slashed its outlook for the current quarter and full year, and issued downbeat earnings guidance for 2016, as the drugmaker deals with the fallout from its relationship with a controversial mail-order pharmacy. Shares in Valeant, down 53% over the past three months through Tuesday鈥檚 close, fell 4.2% in premarket trading. (Beilfuss, 12/16)
Embattled Valeant Pharmaceuticals has slashed its expectations for the fourth quarter and all of 2015, with about two weeks left in both, and issued a guarded outlook for next year as well. But shares of the Canadian drug company jumped more than 3 percent in premarket trading Wednesday, continuing a rally that started Tuesday after Valeant announced a new distribution deal with Walgreens and plans to line up more pharmacies to sell its products. (12/16)
News outlets also report on Bayer's search for takeover targets -
Bayer will keep looking for takeover targets in the consumer health market even as it digests the $14 billion purchase of Merck & Co businesses, to stay at least among the top three players in the industry. "I'm always interested in acquisitions," the German drugmaker's divisional head Erica Mann told journalists at an event in Basel, Switzerland. (12/16)
In addition, hepatitis C and other specialty drug costs impact public program budgets -
A drug that can cure hepatitis C was one of the top pharmaceutical costs in most states' Medicaid budgets in 2014. All told, 33 states spent more than $1 billion to treat the disease with Gilead Sciences' Sovaldi. (Kodjak, 12/15)
One of the nation's biggest health care buyers, the California Public Employees' Retirement System, said its specialty drug costs soared 32% last year to $438 million. Despite being less than 1% of all prescriptions, specialty drugs accounted for nearly a quarter of the pension fund's $1.8 billion in total drug costs, according to a new report by the agency. (Terhune, 12/15)
FTC Counters Health Care Antitrust Accusations From Republicans
A top Federal Trade Commission official is denying accusations by congressional Republicans and medical providers that the health care law has triggered excessive industry consolidation. Federal antitrust rules can regulate competition in harmony with the health care law, the White House's landmark legislative achievement, according to Deborah Feinstein, director of the FTC鈥檚 Bureau of Competition. Republicans have criticized the health law, which mandates that individuals carry health insurance or face a penalty, since its passage in 2010. Republicans have pointed to statistics showing that mergers among hospitals nearly doubled between 2009 and 2013. (Chamseddine, 12/15)
In other cost news, a new study is out that could turn health care economics on its head -
There's a study out today that examines new data about how much we're paying for our care and what hospital mergers in various cities have to do with that. Marketplace Healthcare Reporter Dan Gorenstein explains. (Ryssdal, 12/15)
Public Health
Privately Run Homes For Disabled Amassing Grim Record Of Abuse, Investigation Finds
Three years ago, it looked like the Florida agency that oversees care for children and adults with disabilities had finally had enough. It filed a legal complaint that outlined horrific abuse at Carlton Palms, a rambling campus of group homes and classrooms near the small town of Mount Dora. A man called 鈥淩.G.鈥 was punched in the stomach, kicked and told 鈥渟hut your f-ing mouth,鈥 the complaint said. 鈥淩.T.鈥 was left with a face full of bruises after a worker hit him with a belt wrapped around his fist. A child, 鈥淒.K.,鈥 who refused to lie face down so he could be restrained, was kicked in the face and choked until, eyes bulging, he nearly passed out. (Vogell, 12/15)
Older women at risk for type 2 diabetes may want to break up prolonged periods of sitting by standing or going for short walks, suggests a new study from the UK. Researchers found standing up or walking every so often improved blood sugar, or glucose, levels among postmenopausal women at risk for diabetes, compared to those who sat for 7.5 hours. (Seaman, 12/14)
When it comes to licensing, the nursing profession works almost exactly the way it does with driving a car 鈥 at least in half the states. A nurse with a license from one of those 25 states can practice in any other state that has signed on to a reciprocal licensing compact. Contrast that with doctors. A doctor licensed in one state who wants to practice in another still needs a license from the other state. That鈥檚 a costly and time-consuming process, especially in an era when many health plans and their employees operate across state lines and the use of telemedicine, in which patients and their providers interact from a distance, is growing. (Ollove, 12/11)
A paper out in the journal PLOS Medicine says two main barriers to achieving diverse clinical trials are the expense of recruiting minority subjects, and fears of exploitation in medical research. (Bichell, 12/15)
State Watch
Civil Rights Complaint Alleges Discrimination In California's Medi-Cal Program
A coalition of civil rights advocates Tuesday called for a federal investigation of California鈥檚 Medicaid program, alleging that it discriminates against millions of low-income Latinos by denying them equal access to health care. (Gorman, 12/15)
A fourth major hospital and clinic system signed contracts with managed-care companies that are supposed to start running Iowa鈥檚 Medicaid program soon, the governor鈥檚 office announced Tuesday. Mercy Health Network has signed contracts with WellCare and AmeriHealth Caritas, state officials said. Mercy joins the Genesis, University of Iowa and UnityPoint systems, which Gov. Terry Branstad announced Dec. 3 had signed contracts with for-profit managed-care companies. (Leys, 12/15)
The Triad's largest health systems are among a group of 11 statewide that are joining to create a company seeking to manage the delivery of health care to North Carolina's Medicaid population. The new company, which is still in the formative stages, will fit into a new framework for managing how North Carolina administers and pays for care for its Medicaid population that was adopted by the state legislature earlier this year. (Covington, 12/15)
Oregon Health Authority has named biostatistician Lori Coyner as the state's next Medicaid director. Coyner has worked for OHA since 2013, and was most recently the director of health analytics. She led the development of key aspects of Oregon's health care transformation project, including the incentive metrics for coordinated care organizations an the Hospital Transformation Performance Program. She also developed the CCO rate-setting methodology this year. (Yoo, 12/15)
Michigan State Board Approves $1.2M More In Planned Parenthood Funding Despite Opposition
Despite strong opposition push back from a group of 29 Republican members of the House of Representatives, the state Administrative Board approved a $1.2-million addition to a federal contract with Planned Parenthood of Mid and South Michigan to provide health services for women. The State Administrative Board pulled the Planned Parenthood contract off the agenda last week after the GOP lawmakers wrote a letter to the board objecting to the contract with the organization. (Gray, 12/15)
A U.S. judge on Monday temporarily blocked Ohio from initiating legal action against three Planned Parenthood facilities the state's attorney general accused last week of violating rules for disposal of fetal remains. Planned Parenthood, which denied violating any state rules, sued Ohio in U.S. District Court, saying state Attorney General Mike DeWine had singled out the organization over all other healthcare providers in violation of its rights to due process and equal protection under the U.S. Constitution. (Palmer, 12/14)
State Highlights: In Move To Fight Fraud, Minn. Cuts Ties With Mental Health Agency; Fla. 'Docs Vs. Glocks' Law Upheld
In a highly unusual move, the Minnesota Department of Human Services has terminated payments to a large Twin Cities mental health provider accused of overbilling Medicaid by millions of dollars. The move is part of a broader state effort to crack down on Medicaid fraud, but it is also prompting fears that dozens of people with psychiatric disorders could be stranded without necessary services. (Serres, 12/15)
Rejecting constitutional arguments, a federal appeals court Monday again upheld a controversial Florida law that restricts doctors from asking questions and recording information about patients' gun ownership. After a July ruling by a three-judge panel, opponents of the 2011 law asked for the full appeals court to take up the issue. Instead, the same three-judge panel issued a revised ruling Monday that unanimously backed the law. (12/15)
Gov. Rick Scott鈥檚 proposed state budget includes $5 million for the creation of a database that would show all the costs and expenses associated with hospital treatment and other health care. Scott says hospitals would have to post what they actually get paid for every procedure in order to prevent price gouging. He says patients and insurance companies should know the cost of health care treatments up front, just as consumers know the cost of items at the grocery store. (Jordan, 12/15)
Maryland's Prince George鈥檚 County officials are projecting an estimated 30 percent drop in the number of uninsured residents and modest increases in new enrollees. 鈥淚t鈥檚 having a significant impact,鈥 County ACA program manager Shari Curtis says. (Hern谩ndez, 12/15)
About 20,000 uninsured adults in St. Louis city and county will have access to basic health services for another year, after the federal government approved a one-year grant extension Tuesday. Coverage for 2015 was scheduled to expire on December 31. The measure sends up to $30 million to the Gateway to Better Health Program, which is intended as a stop-gap for people who would have been covered if the state of Missouri had expanded Medicaid. (Bouscaren, 12/15)
Problems with insurers鈥 contracts with physicians 鈥 and with their provider networks 鈥 are likely to spark legislation in the upcoming General Assembly session, a key state senator said Monday. State Sen. Dean Burke (R-Bainbridge), who chaired a legislative study committee reviewing insurer networks and contracts, told GHN that the panel鈥檚 work may lead to three separate bills in the Legislature next year. (MIller, 12/15)
Watchful Ohioans will gain some protection from surprise medical bills as well as greater knowledge about insurance plans鈥 provider networks under a rule that takes effect in January. The rule, put in place by the state Department of Insurance, will require health-insurance companies to update their directories of health-care providers at least every three months. (Sutherly, 12/15)
Editorials And Opinions
Viewpoints: Mental Illness Not To Blame For Most Violent Acts; Congress Must Reinvest In Medical Research's Promise
Those who oppose expanded gun-control legislation frequently argue that instead of limiting access to guns, the country should focus on mental health problems. But mass shootings represent a small percentage of all gun violence, and mental illness is not a factor in most violent acts. (Editorial Board, 12/15)
Seventeen years ago, Democrats and Republicans in Congress made a promise to the American people. We would invest in our nation鈥檚 brightest minds. We would spur medical innovation. And, most important, we would find treatments and cures for the diseases that devastate families and debilitate our economy. Congress fulfilled that promise by doubling funding for the National Institutes of Health over five years between 1998 and 2003. Begun during the Clinton administration and completed under President George W. Bush, this was a bipartisan, bicameral achievement with few equals in our recent history. (Tom Harkin and John Porter, 12/15)
Emergency rooms are typically a catch-all, especially for people without health insurance. It's a safety net, but also too easy to misuse. It's a system that can't sustain itself because of the cost of care and demands of the county's growing population. With the Affordable Care Act the healthcare landscape continues to change. Today, emergency rooms are much different. (Jeff Brandt, 12/15)
The Alaska Congressional delegation and the Republican Party suffer from "Obamacare" repeal syndrome, a chronic condition since 2010. The symptoms are a compulsion to selectively use statistics and exaggerate the downside, ignoring all positive aspects of the law, including evidence the health care law has helped people get health insurance coverage -- thousands in Alaska and millions across the U.S. (Dermot Cole, 12/15)
Last month, the Organization for Economic Cooperation and Development, a developed-country think tank, released its latest estimates of how much the rich world spends on health care. Yet again, the United States took the top spot. Our nation spends $8,713 per person on health care 鈥 more than double the OECD average. A separate analysis by Bloomberg puts U.S. spending even higher 鈥 at $9,146 per person. (Sally Pipes, 12/14)
Politics is a poker game 鈥 no matter how bad the other guy鈥檚 hand might be, you can鈥檛 beat something with nothing. So let鈥檚 review the hands Republicans and Democrats are playing on ObamaCare. At the moment, Republicans in Congress are looking at their cards and smiling. (Juan Williams, 12/14)
Former U.S. Health and Human Services Secretary Kathleen Sebelius staked out a sound economic case on Monday while criticizing attempts in Missouri and Kansas to restrict family planning services. Two strong downward drivers of economic mobility are teen pregnancies and unintended pregnancies among women of all ages, Sebelius said. The former Kansas governor was the keynote speaker at the annual conference sponsored by Planned Parenthood of Kansas and Mid-Missouri. (12/14)
Whole Woman鈥檚 Health v. Cole, the Texas abortion case that is now before the Supreme Court, is really about the rule of law and how federal judges maintain it by holding states to external standards. The case follows Planned Parenthood of Southeastern Pa. v. Casey, which forbade states from using the desire to protect women鈥檚 health as a pretext for curtailing their access to abortion services. But how is a judge to distinguish a pretext from a genuine concern for patient safety? (Charles Silver, 12/15)
Would people smoke less if cigarettes were sold in plain packages? Early evidence from Australia, which has required them for three years, suggests they might. The plain packs -- which prohibit design features and logos such as Marlboro's red and white angles or Camel's dromedary, forbid pictures aside from health warnings, and require brand names to be in a uniform typeface -- reduce the appeal of cigarettes, research indicates, and prompt people to think more about quitting. (12/15)