Kaiser Health News Original Stories

1. Tiny Opioid Patients Need Help Easing Into Life

More babies are being born dependent on opioids. The good news is they can safely be weaned from the drug. But there's little research on which medical treatment is best, or its long-term effects. (Kristin Espeland Gourlay, RINPR, 3/28)

2. Pharmaceutical Company Has Hiked Price On Aid-In-Dying Drug

Valeant Pharmaceuticals, the company that makes Seconal, the drug most commonly used in prescribed for terminally ill patients who want to end their lives, physician-assisted suicide, has doubled the price to more than $3,000. (April Dembosky, KQED, 3/28)

4. Political Cartoon: 'Ripple Effect'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Ripple Effect'" by Chris Wildt .

Here's today's health policy haiku:

STUDY FINDS PRIMARY DOCTORS OFTEN DON'T HELP PATIENTS MANAGE DEPRESSION

Primary care docs
Help those with depression less.
This is depressing.

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Health Law Issues And Implementation

5. Idaho House Kills Senate Plan On Medicaid Expansion

The vote came shortly before the House adjourned for the year. Also, a look at the Medicaid expansion debate in Tennessee.

Idaho Statesman: Idaho House Kills Medicaid Expansion Bill
House Republicans Friday gave the decisive last word on the session-long debate over funding health care for 78,000 lower-income Idahoans, voting unanimously to kill a Senate-approved bill to move the state toward a federally-approved, Idaho-driven solution. After lengthy morning caucuses of party leaders and then the rank-and-file, Republicans moved not to accept the amended version approved in the Senate Thursday. (Dentzer, 3/25)

The Tennessean: Study Heralds Medicaid Expansion Benefits As Rural Hospital Closes
States that expanded Medicaid programs using federal funding are reaping economic benefits, a new study finds as the long-running healthcare debate rages anew in Tennessee's legislature. Tennessee is among 19 states that have, thus far, opted to not expand coverage to those who fall in the uninsured gap between qualifying for traditional Medicaid and being qualified to buy insurance on the federally run exchange. ... Insure Tennessee, a tiered coverage system using federal Medicaid expansion funding, was pitched to the legislature ahead of a 2015 special session, as well as heard in regular session, but Senate committees blocked the proposal over concerns with a variety of issues. (Fletcher, 3/25)

Campaign 2016

6. Questions Remain Over What Happens After Cruz's Scorched-Earth Approach To Health Law

The Republican candidate has yet to lay out a health care insurance plan to replace the Affordable Care Act, and as he heads into Wisconsin, the land of House Speaker Paul Ryan and Gov. Scott Walker, some say he is missing an opportunity to capitalize on the issue. In other 2016 election news, Chelsea Clinton talks about the "crushing costs" of health care, but KHN's Julie Rovner discusses how the issue has mostly faded into the background.

Politico: Cruz's Missing Obamacare Replacement Plan
Everyone knows how Ted Cruz feels about Obamacare. He’s the guy who shut down the government in a bid to kill it — and should he reach the White House, he’d take a blowtorch to the law. But Cruz isn’t very clear about what — if anything — he’d do to replace a law covering 20 million people. And some establishment Republicans suggest that he address this head-on before the pivotal April 5 primary in Wisconsin, where Republican leaders have been more aggressive in fleshing out alternative health plans. (Pradhan and Demko, 3/27)

Kaiser Health News: Health Care Fades Into The Background Of 2016 Election Cycle
With Obamacare battles largely behind us, presidential candidates in 2016 seem focused on other issues. Health care played starring roles in the 2008 and 2012 election cycles. President Obama's Affordable Care Act became the battle cry of politicians hoping to ascend to the highest office in the land. But Obamacare passed through the gauntlets of the U.S. Congress and Supreme Court, and came out in tact. Whether it's fatigue with the topic of health care, a shift in the public's priorities, or other campaign year distractions, how we pay for our doctor's visits has fallen from the top of the nation's priorities list. (Rovner, 3/28)

Administration News

7. FDA Delays Calorie Labels Requirement For Restaurants Until 2017

Under the health law establishments that prepare and serve food and have 20 or more locations will be required to put calorie labels on their menus, but the Food and Drug Administration -- after saying last year the rules would be in place at the end of 2016 -- has put off the requirements until next year.

The Associated Press: Looking For Calorie Labels On Menus? Not Until 2017
Wondering how many calories are in that hamburger? Chain restaurants still don't have to tell you, despite a 6-year-old law requiring calorie labels on menus. Passed as part of the health care overhaul in 2010, the rules will eventually require restaurants and other establishments that sell prepared foods and have 20 or more locations to post the calorie content of food "clearly and conspicuously" on their menus, menu boards and displays. This month, the Food and Drug Administration said it will delay the rules — again — until 2017. (Jalonick, 3/28)

In other FDA news, a leading cancer expert blasts the agency for being slow to approve promising drugs —

The Miami Herald: Cancer Drugs And The FDA: Safety Vs. Saving Lives
One of America's leading cancer experts says many lives could be saved if patients got the best available treatment — and he places considerable blame on federal regulators for being slow to approve desperately needed drugs. “There are incredibly promising therapies out there,” writes Dr. Vincent T. DeVita Jr., former director of the National Cancer Institute. (Dorschner, 3/26)

Quality

8. A Quiet Revolution: Arkansas Doctors Changing The Way They Look At Health Care

In a state-wide effort to improve health care quality, providers have begun concentrating on what happens after the patients leave the doctor's office.

Los Angeles Times: How A Healthcare Revolution Came To One Red State While The Obamacare Battle Raged On
Winnie Abbott desperately wanted a knee replacement when she came to Dr. Jeffrey Angel’s office here in the foothills of the Ozark Mountains. Before Angel would operate, though, he had some requests for Abbott. She should take a class about the procedure and designate a family member to be her “coach” to help with recovery. And if she had problems after surgery, she needed to call a 24-hour number at Angel’s office rather than just go to the emergency room. This comprehensive approach to patients – focused not just on what happens in the doctor’s office but on how patients recover at home and how much their care costs – hasn’t always been the rule in American healthcare. But across the country, far from the vitriolic debate over Obamacare, it is driving a quiet revolution that is changing how doctors replace knees, communicate with patients, prescribe drugs, even deliver babies. (Levey, 3/25)

Public Health And Education

9. Synthetic Painkiller Fentanyl Is The Latest Wave In Drug Epidemic

The drug, which can be 50 times more powerful than heroin and up to 100 times more potent than morphine, is causing, in some places, more deaths than heroin. “For the cartels, it’s their drug of choice,” says Maura Healey, the attorney general of Massachusetts. “They have figured out a way to make fentanyl more cheaply and easily than heroin and are manufacturing it at a record pace.”

The New York Times: Heroin Epidemic Is Yielding To A Deadlier Cousin: Fentanyl
When Eddie Frasca was shooting up heroin, he occasionally sought out its more potent, lethal cousin, fentanyl. “It was like playing Russian roulette, but I didn’t care,” said Mr. Frasca, 30, a carpenter and barber who said he had been clean for four months. When he heard that someone had overdosed or even died from fentanyl, he would hunt down that batch. “I’d say to myself, ‘I’m going to spend the least amount of money and get the best kind of high I can,’ ” he said. Fentanyl, which looks like heroin, is a powerful synthetic painkiller that has been laced into heroin but is increasingly being sold by itself — often without the user’s knowledge. (Seelye, 3/25)

Meanwhile, Kaiser Health News and Stateline report on how the epidemic is affecting expecting mothers and their babies —

Kaiser Health News: Tiny Opioid Patients Need Help Easing Into Life
Swaddled in soft hospital blankets, Lexi is 2 weeks old and weighs 6 pounds. She's been at Women and Infants Hospital in Providence, Rhode Island since she was born, and is experiencing symptoms of opioid withdrawal. Her mother took methadone to wean herself from heroin when she got pregnant, just as doctors advised. But now the hospital team has to wean newborn Lexi from the methadone. As rates of opioid addiction have climbed in the U.S., the number of babies born with neonatal abstinence syndrome has increased, too — by five-fold from 2000 to 2012, according to the National Institute of Drug Abuse. (Gourlay. 3/28)

Stateline: Demand Surges For Addiction Treatment During Pregnancy
Nationwide, the number of pregnant women using heroin, prescription opioids or medications used to treat opioid addiction has increased more than five-fold and it’s expected to keep rising. With increased opioid and heroin use, the number of babies born with severe opioid withdrawal symptoms has also spiraled, leaving hospitals scrambling to find better ways to care for the burgeoning population of mothers and newborns. Among the most important principles is that expectant mothers who are addicts should not try to quit cold turkey because doing so could cause a miscarriage. Trying to quit opioids without the help of medications also presents a high risk of relapse and fatal overdose. (Vestal, 3/25)

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