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KHN First Edition: March 30, 2016


First Edition

Wednesday, March 30, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Pregnant And Addicted: The Tough Road To A Healthy Family
WCNP's Sarah Jane Tribble, in partnership with Kaiser Health News and NPR, reports: "Amanda Hensley started abusing prescription painkillers when she was just a teenager. For years, she managed to function and hold down jobs. She even quit opioids for a while when she was pregnant with her now 4-year-old son. But she relapsed. Hensley says she preferred drugs like Percocet and morphine, but opted for heroin when short on cash. By the time she discovered she was pregnant last year, she couldn't quit." (Tribble, 3/30)

Kaiser Health News: Supreme Court Asks For More Information In Birth Control Case
Kaiser Health News staff writer Julie Rovner reports: "An apparently deadlocked Supreme Court is asking lawyers in a closely watched health law case to provide more information on how women working for religious employers might be able to get insurance coverage for contraception without violating the rights of their bosses. The order also included a request for information about a scenario that might be a possible compromise in the case." (Rovner, 3/29)

Kaiser Health News: Fantasy Sports Fueling A Rise In Online Gambling Addiction
Kaiser Health News staff writer Ana B. Ibarra reports: "Poison comes in many forms for addicts: Alcohol and drugs usually come first to mind, but gambling -- often overlooked -- is of increasing concern to state officials and rehab centers. The number of problem gamblers has grown in recent years with an explosion of betting opportunities available at the touch of a smartphone screen. That is particularly true during this month’s annual “March Madness” college basketball tournament." (Ibarra, 3/30)

The New York Times: Newest Policyholders Under Health Law Are Sicker And Costlier To Insurers
People newly insured under the Affordable Care Act were sicker, used more medical care and had higher medical costs than those who already had coverage, the Blue Cross and Blue Shield Association said Tuesday in a new study of its policyholders. Because insurers’ premiums have to cover their medical expenses, the new report helps explain why Blue Cross plans have sought, and insurance commissioners have approved, substantial rate increases in many states. (Pear, 3/30)

The Associated Press: Report Details Costs, Challenges Of ACA's Newly Insured
Health insurers gained a sicker, more expensive patient population after the Affordable Care Act expanded coverage in 2014, according to an early look at medical claims from the Blue Cross Blue Shield Association, which represents the most common brand of insurance. Newer customers had higher rates of diabetes, depression and high blood pressure, among other conditions, the association said in a report released Wednesday. (3/30)

The Washington Post: They’re Sicker, Plus ACA Enrollees Cost More In Care, Major Insurer Finds
Medical costs for individuals who obtained coverage through the ACA’s insurance exchanges were, on average, 22 percent higher than those with employer-based coverage in 2015, according to the association. Average monthly medical spending per member was $559 for individual enrollees in 2015, for example, versus $457 for group members. ... Under the law, no one can be denied coverage because of a pre-existing medical condition. Researchers and policy experts have always predicted that new enrollees during the first few years would include many older, sicker consumers who previously lacked insurance. (Sun, 3/30)

The Wall Street Journal: Affordable Care Act Enrollee Spending Is Increasing
The report was released by the Blue Cross Blue Shield Association, which represents the Blue insurers, most of which are not-for-profit. The group may be airing an early defense for further premium increases, said Sam Glick, a partner with consulting firm Oliver Wyman, a unit of Marsh & McLennan Cos. “It’s making it clear the populations they are serving may be higher cost, and trying to lay some of the groundwork for rate increases and defending their tax-exempt status,” he said. A spokesman for the Department of Health and Human Services said it was “no surprise that people who newly gained access to coverage under the Affordable Care Act needed health care,” noting that people with pre-existing health conditions often couldn’t buy plans before ACA changes in 2014. (Wilde Mathews, 3/30)

The New York Times: Supreme Court Hints At Way To Avert Tie On Birth Control Mandate
The Supreme Court on Tuesday issued an unusual order indicating that the justices are trying to avoid a 4-to-4 deadlock in a case pitting religious freedom against access to contraception. The order, which was unsigned, directed the parties to file supplemental briefs in Zubik v. Burwell, No. 14-1418, which was argued on Wednesday. The case was brought by religious groups that object to providing insurance coverage for contraception to their female workers. (Liptak, 3/29)

The Associated Press: Justices Seem To Seek Compromise In Birth Control Case
A seemingly divided Supreme Court is exploring a possible compromise ruling in the dispute between faith-based groups and the Obama administration over birth control. The justices issued an unusual order Tuesday directing both sides in the case that was argued last week to file a new round of legal briefs. (3/29)

The Wall Street Journal: U.S. Supreme Court Asks Parties For Paths To Settling Religious Contraception Case
The court’s request will require plaintiffs to review their legal and theological positions. To date, Catholic bishops, in particular, have said they object to any system that uses their health plan as a vehicle for providing something they believe to be immoral, even if they are not directly involved in handling or paying for contraception. But some critics have said the bishops have much to lose from an adverse ruling and that they may be better off claiming a victory if the opportunity presents itself. The Obama administration could face a similar dilemma. Federal officials have worked for years to refine a system that they believe could address religious objections—while simultaneously responding to calls from women’s groups that they hold firm on keeping contraception covered for everyone through the Affordable Care Act. (Kendall and Radnofsky, 3/29)

Politico: SCOTUS Seeks New Birth Control Policy
The rare, post-oral argument order in the already contentious case provided new glimmers of hope to both sides. The challengers believe the order means the court won’t uphold the existing accommodation. "They wouldn’t be asking about alternatives to the accommodation if they [found it acceptable],” said Eric Rassbach, deputy general counsel at the Becket Fund for Religious Liberty, which represents an order of Catholic nuns, Little Sisters of the Poor, in the case. But government allies are heartened that the court appears strongly concerned with ensuring that employees can seamlessly access contraception through their health plans. (Haberkorn, 3/29)

The Washington Post: Reality Of A Divided Supreme Court: A Split Decision And A Search For Compromise
The reality of an ideologically divided, evenly split, one-man-down Supreme Court became apparent Tuesday: The justices deadlocked on a major organized-labor case and tried to avoid a second stalemate by floating their own policy compromise on the Affordable Care Act’s contraception mandate. The actions underscored how the death of Justice Antonin Scalia has upended business as usual at the Supreme Court. They also provided a preview of the kind of tentative decisions that may be all the eight-member court can muster as it faces a docket filled with election-year controversies. (Barnes, 3/29)

The Wall Street Journal: Supreme Court Struggles to Deal With 4-4 Split
The post-Scalia era burst forth Tuesday at the Supreme Court in a pair of developments that reveal the new dynamic of an eight-member panel equally divided between conservatives and liberals. ... In a separate order later Tuesday, the justices took the extraordinary step of framing their own compromise to a dispute between religious organizations opposed to contraception and the Obama administration, which seeks to ensure female employees receive insurance coverage under the Affordable Care Act. At last week’s arguments the case appeared headed for another 4-4 split between the court’s conservatives and liberals. (Bravin, 3/29)

The New York Times: Obama Steps Up U.S. Effort To Fight Abuse Of Heroin And Painkillers
President Obama, confronting a national epidemic of heroin and prescription drug abuse, met here Tuesday with recovering addicts, doctors and law enforcement officials to underscore his determination to tackle a problem some critics say he left until too late in his administration. “We are seeing more people killed because of opioid overdose than from traffic accidents — I mean, think about that,” Mr. Obama said at a meeting of the National Rx Drug Abuse and Heroin Summit. “It has to be something right up at the top of our radar screen.” (Landler, 3/29)

The Associated Press: Obama Turns Attention To Growing Opioid Abuse Problem
Obama's appearance at the conference came as his administration issued proposed regulations and announced new funding for states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use. The actions also coincide with a commitment from 60 medical schools to heighten training for prescribing opioids. (3/29)

USA Today: Obama Joins Fight Against Opioid Abuse
Given its widespread reach, administration officials announced a wide range of actions to fight the epidemic, such as expanding access to drug treatment, bolstering efforts to ensure health coverage for substance abuse and mental health are on par with benefits for other medical services, investing in partnerships between law enforcement and communities, and providing guidance on using federal funds to start or expand needle exchanges. Surgeon General Vivek Murthy, meanwhile, said he will release a report later this year on substance use, addiction and health, similar to the landmark surgeon general’s report on smoking released 50 years ago that focused public attention on that issue. (Ungar, 3/29)

The Washington Post: Obama Anti-Heroin Strategy Shifts Focus To Treatment From Arrests
President Obama mounted his bully pulpit Tuesday in an attempt to change the focus on heroin and opioid addiction from a criminal problem to a health issue. It would be a major shift in emphasis if he succeeds. “The only way that we reduce demand is if we’re providing treatment and thinking about this as a public health problem and not just a criminal problem,” he said to cheers and applause. Obama also acknowledged that more attention is being paid to addiction as a health issue now that it is seen as a growing threat to white communities, instead of primarily a low-income black and brown police matter. (Davidson, 3/29)

The Wall Street Journal: Obama Announces New Measures To Combat Heroin, Painkiller Abuse
Among the new measures the Obama administration outlined was stepped-up enforcement of laws that require health plans’ coverage of mental-health and substance-abuse treatment to be comparable to medical and surgical benefits. A new rule by the Department of Health and Human Services will improve access to drug treatment for people enrolled in Medicaid and the Children’s Health Insurance Program by requiring such parity. The move is expected to benefit more than 23 million people, according to the White House. (Campo-Flores, 3/29)

The Washington Post: Amid ‘Heartbreaking’ Stories, Obama Pushes For More Funding To Treat Addiction
During an emotional and often intensely personal panel discussion, President Obama listened Tuesday as a 35-year-old mother of two described her descent from prescription drugs into heroin addiction. “It slowly happened,” said Crystal Oertle of Ohio as she sat beside the president. “It is crazy to think of the things I did, but it was necessary for me to function.… I’ve had to steal. I have stolen from department stores to feed my habit. I have been involved in drug busts a couple of times.” She has now marked a year of recovery. (Jaffe, 3/29)

The Wall Street Journal: Lawmakers Target Medivation Over Drug Prices
A cancer drug that costs $129,000 a year—more than three times the price in Japan and Sweden and four times the Canadian cost—has become the latest subject of public and congressional scrutiny, as 12 representatives joined nonprofits to call for a public hearing on the drug’s price. Xtandi, a prostate cancer drug co-licenced by Japan’s Astellas Pharma Inc. and Medivation Inc., was developed at a U.S. university with grants funded by taxpayer dollars. That gives the federal government the right to revoke the patent if the terms are unreasonable, said the letter, dated Monday. (Court, 3/29)

The Associated Press: Makers Of Pricey Prostate Cancer Drug Xtandi Are Targeted By Congress
In a letter to the heads of the Department of Health and Human Services and the National Institutes of Health, Reps. Lloyd Doggett (D-Texas) and Welch (D-Vt.) and Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) urged the agencies to step in to cut prices for Xtandi, saying it costs four times as much in the U.S. as in some other developed countries. They are asking for public hearings on the drug. The lawmakers want the NIH to consider overriding Xtandi's patent, which guarantees Medivation and Astellas exclusive sales for a decade or more. Overriding the patent would allow for Xtandi's price to be reduced. (3/29)

NPR: Physician Group Calls On Government To Rein In Drug Prices
It's not just patients who are getting tired of ever rising drug prices. Doctors are joining the chorus of frustration. The latest voice? The American College of Physicians, whose membership includes 143,000 internal medicine doctors. It published a position paper Monday calling for the government and industry to take steps to rein in spiraling costs. "This is consistent with our mission to put the patient first," Dr. Wayne Riley, ACP president, tell Shots. We've heard from our patients, and our patients are frustrated with dealing with this." (Kodjak, 3/29)

The Wall Street Journal: Drug Pricing Issue Still Plagues Biotech
It seems that politicians aren’t going to drop the issue of high drug prices any time soon. That is a problem for biotechnology investors. A dozen congressional Democrats sent a letter to senior officials at the Department of Health and Human Services and National Institutes of Health regarding the high price of a prostate cancer treatment, Xtandi. The members of Congress, who called for hearings over the drug’s price, noted in their letter that existing law allows the NIH to help lower the price of the drug. (Grant, 3/29)

The New York Times: Report Finds Sharp Increase In Veterans Denied V.A. Benefits
Former members of the military ... are being refused benefits at the highest rate since the system was created at the end of World War II, the report said. More than 125,000 Iraq and Afghanistan veterans have what are known as “bad paper” discharges that preclude them from receiving care, said the report, released Wednesday by the veterans advocacy group Swords to Plowshares. The report for the first time compared 70 years of data from the Departments of Defense and Veterans Affairs. (Philipps, 3/30)

The New York Times: Shaping Health Policy For Millions, And Still Treating Some On The Side
On weekdays, Dr. Patrick H. Conway is one of the most powerful doctors in America, steering federal health programs that spend nearly $1 trillion a year while shaping health policies that affect tens of millions of citizens. On many weekends, he is just another doctor in blue sterile gloves and a yellow gown with a stethoscope around his neck, comforting children and training young physicians, many of whom have no idea of his other role. (Pear, 3/29)

The Associated Press: Caregivers Of People With Dementia Face Financial Hardships
Many relatives and friends providing financial support or care to people with dementia have dipped into their retirement savings, cut back on spending and sold assets to pay for expenses tied to the disease, according to a survey released Wednesday by the Alzheimer's Association. About one in five go hungry because they don't have enough money. (3/30)

NPR: Big Financial Costs Are Part Of Alzheimer's Toll On Families
First, Alzheimer's takes a person's memory. Then it takes their family's money. That's the central finding of a report published Wednesday by the Alzheimer's Association on the financial burden friends and families bear when they care for someone with dementia. "What we found was really startling," says Beth Kallmyer, vice president of constituent services for the organization. "The cost of paying for care was putting people in a situation where they had to make really difficult choices around basic necessities — things like food, medical care, transportation." (Hamilton, 3/30)

The Wall Street Journal: New York State Budget Talks Hit Medicaid Hurdle
Assembly Speaker Carl Heastie said he remained concerned Tuesday about Gov. Andrew Cuomo’s plan for Medicaid spending, a sticking point as negotiations over New York’s $154 billion budget inched toward a Friday deadline. In an informal, impromptu conversation with reporters at his Capitol office, Mr. Cuomo, a Democrat, pledged to find $250 million in Medicaid savings before completing a budget agreement with legislative leaders. (Vikensky and Orden, 3/29)

The New York Times: Medicaid Joins Minimum Wage As Complication In Budget Talks
Of this, everyone in the State Capitol seems certain: New York will eventually have a budget. The question is when. ... While a deal appeared close, there was still noticeable aggravation in Democratic ranks over a plan that Mr. Cuomo unveiled in January: finding some $250 million in Medicaid savings, much of which would come from New York City, which accounts for a large chunk of Medicaid spending statewide. (McKinley and Yee, 3/29)

The Associated Press: Health Dept.: Medicaid Expansion Could Lessen, Not Stop Cuts
The chief financial officer of Louisiana's health department says Medicaid expansion could save the state $124 million next year to help lessen the blow of budget cuts. Gov. John Bel Edwards' administration says Louisiana could take advantage of enhanced federal financing to produce savings if it expands Medicaid to cover the working poor. But even with those savings, Jeff Reynolds told a House budget committee Tuesday the Department of Health and Hospitals still faces deep reductions that could shutter several privatized LSU hospitals. (3/29)

The Associated Press: Report Targets Louisiana Jails For Inadequate HIV Care
Louisiana's locally-run jails fail to provide inmates with proper HIV testing and treatment, in a state with some of the highest HIV infection rates in the country, according to a report released Tuesday by the National advocacy group Human Rights Watch. Megan McLemore, author of the 70-page report and senior health researcher with Human Rights Watch, called Louisiana "ground zero" for nationwide HIV and incarceration issues from the steps of the Capitol Tuesday. (3/29)

The Washington Post: A Doctor Removed The Wrong Ovary, And Other Nightmare Tales From California Licensing Records
The main job of state medical boards is to license doctors and to investigate complaints. But their findings are often difficult for the average consumer to access, meaning that ma

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