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Campaign 2016

4. 'Tremendous Consensus' In Anti-Abortion Movement Over Trump's 'Punishment' Comments

Although there wasn't time to compare talking points, leaders in the movement said there was no need: It's wrong, they all agreed. Meanwhile, the Republican front-runner is blaming a "convoluted" interview for his statement that, if abortions were banned, a woman who had one should be punished. "It could be that I misspoke," he also acknowledged.

The Associated Press: Trump Says Abortion Comments Were Taken Out of Context
Republican presidential candidate Donald Trump now says his contentious comments on abortion were taken out of context. Trump was answering questions during an MSNBC town hall taping Wednesday when he said there should be "some form of punishment" for women who get abortions if the procedure is outlawed. He later reversed his position in a statement. In an interview Thursday night on Fox News Channel's "The O'Reilly Factor," Trump blamed the flub on a "convoluted" interview. (3/31)

The New York Times: Donald Trump Acknowledges Misstep On Abortion Question
Donald J. Trump on Thursday allowed that he might have misspoken on the topic of abortion when he told the MSNBC host Chris Matthews that women who have abortions should face some form of punishment if the procedure is banned. But he insisted the media attention to a misstep — amid the volume of questions he answers — gets outsize attention. “If you answer one question inartfully or incorrectly in some form, or you misunderstood it or you misspoke, it ends up being a big story,” he said. “That doesn’t happen with other people.” (Haberman, 3/31)

The Associated Press: Anti-Abortion Movement Unified In Swift Rebuke Of Trump
Trump soon backtracked from Wednesday's comments, but not before anti-abortion leaders forcefully repudiated him. "There was no time to get on the phone and compare talking points, but all the comments were consistent," said Mike Gonidakis, president of Ohio Right to Life. "The foundational premise of the pro-life movement is to protect both the mother and the unborn child. We don't leave one of them behind." The anti-abortion movement is by no means monolithic — there are sometimes sharp splits over political tactics and the question of whether abortion bans should make exceptions for rape and incest. But there is common ground around the belief that life begins at conception, and a consensus that this belief takes precedence over short-term political calculations. (3/31)

In other news, The Washington Post fact checks Carly Fiorina's portrayal of Hillary Clinton's abortion stance —

The Washington Post's Fact Checker: Fiorina’s Claim That Hillary Clinton Supports Abortion ‘Up Until The Moment’ Of Birth
Former GOP presidential hopeful Carly Fiorina, now a supporter of Sen. Ted Cruz (R-Tex.), appeared on Fox to make the case that front-runner Donald Trump had fishy credentials as an opponent of abortion rights, even before Trump caused new controversy for saying women who get abortions should be punished. But we were also interested in her attack on Hillary Clinton’s abortion position. Is it correct that Clinton supports abortion up to the moment of birth? (Kessler, 4/1)

And the governor of Arizona says he "stand[s] with those advocating life," after signing three bills targeted at limiting abortions, and medical schools and universities say House subpoenas over fetal research are a safety risk —

The Associated Press: Arizona Governor Signs 3 Bills Targeting Abortion Providers
Arizona Gov. Doug Ducey on Thursday announced he had signed three bills targeting abortion providers, including one requiring them to follow outdated federal guidelines for the most common abortion drug and prescribe it at much higher doses than needed. The law boldly defies new FDA rules implemented this week on abortion drugs. The signing of the bill, Senate Bill 1324, is likely to jump-start a federal court case that had blocked a previous version of the legislation. The bill bars doctors from prescribing the drug commonly known as RU-486 after seven weeks of pregnancy and requires it to be taken only at Food and Drug Administration-approved doses in effect until this week. It also requires the two doses of the drug to be taken at a clinic, while providers now send the patient home with the second pill to be taken days after the first. (3/31)

The Hill: Universities Protest Subpoenas For Fetal Tissue Researchers' Names
Medical schools and universities are protesting Republicans’ decision to issue subpoenas for the names of researchers involved in fetal tissue studies, saying it could put their safety at risk. The Association of American Medical Colleges, which represents all of the country’s medical schools, expressed its “significant concerns” in a letter on Thursday to the heads of the congressional committee set up to investigate Planned Parenthood. (Sullivan, 3/31)


5. Medicare Implements New Payment Rules For Hip And Knee Replacements In 67 Cities

The move seeks to get hospitals to better coordinate care with doctors and rehab centers by making the hospitals accountable for the costs of the operation and follow-up services for 90 days.

The Wall Street Journal: Hospitals Brace For New Medicare Payment Rules
Starting Friday , nearly 800 U.S. hospitals face sweeping new payment rules that could have a direct impact on their bottom line, but not everyone is ready, industry experts say. The rules will hold hospitals accountable for all the costs of hip and knee replacements for 90 days. If patients recover and go home quickly, hospitals could reap savings. If they have complications or need lengthy stays in a rehab facility, hospitals could owe Medicare instead, starting next year. (Beck, 3/31)

The Associated Press: Medicare Opens New Push On Hip, Knee Replacement
From Akron to Tampa Bay, from New York City to San Francisco, Medicare on Friday launches an ambitious experiment changing how it pays for hip and knee replacements in an effort to raise quality and lower costs. The idea is to follow patients more closely to smooth their recovery and head off unwanted complications that increase costs. Hip and knee replacements are the most common inpatient surgery for beneficiaries, and Medicare will be using financial rewards and penalties to foster coordination among hospitals, doctors, and rehab centers. Improved care should also reduce costs, the government says. (Alonso-Zaldivar, 3/31)

Toledo Blade: Medicare Alters Payment Plan For Joint Replacement
The Toledo Metropolitan Statistical Area, which includes Lucas, Wood, and Fulton counties, and 67 other metro areas have a new mandate from Medicare. A five-year pilot program will track joint-replacement surgery patients for three months and combine the costs for surgery and any associated care into a single payment. Federal officials call this a “target price” or “bundled payments.” ... Putting hospitals in the position of managing the patient’s quality of care and costs three months after the surgery has forced closer collaboration between hospitals and local rehabilitation centers, [said Shannon Holley, associate vice president of patient care and operations at ProMedica]. (Harris-Taylor, 4/1)

Lincoln (Neb.) Journal-Star: Lincoln Among Cities In New Medicare Payment Program
Medicare patients getting hip and knee replacement surgeries at Lincoln hospitals will be part of a new payment program starting Friday. Lincoln is one of 67 metro areas in the U.S. -- and the only one in Nebraska -- where Medicare will debut a new bundled payment program for those surgeries. ... Doctors, hospitals, rehab centers, therapists, home health agencies and other providers will continue to get their regular reimbursements from Medicare. But at the end of the year, hospitals will be held accountable for the total cost of care over the 90-day period. "Everybody's going to get paid the same, but it's just the hospitals taking the risk," said Robb Linafelter, CEO of the Lincoln Surgical Hospital. (Olberding, 3/31)

In other Medicare news —

CQ Healthbeat: Groups Wary As Medicare Creates Measures For Judging Doctors
Health professional societies and consumer groups have asked Medicare to tread carefully while overhauling its system for paying doctors, raising concerns about an agency suggestion to include guidelines from a campaign that seeks to curb the use of often unneeded procedures and treatments. Medicare officials are awaiting White House clearance of a draft rule designed to tie payments for doctors to judgments about the quality of care they provide. The Office of Management and Budget has been reviewing this proposal since March 25. The Centers for Medicare and Medicaid Services rule would carry out the changes mandated in last year’s congressional overhaul of Medicare physician payments. (Young, 3/31)

Health Law Issues And Implementation

6. Insurers Cutting Payments To Brokers To Discourage Sales Of Some Health Law Plans

The moves often focus on plans that attract the sickest people.

USA Today: Insurers Cut Commissions To Restrict When And What Plans People Buy
Insurers increasingly are dropping agents' commissions to discourage the sale of the Affordable Care Act plans they're losing the most money on, especially when the consumers are more likely to be sick, according to health care industry officials and experts. The moves by nearly every major insurer over the last few months are often focused on times of the year and plans that attract the sickest people and starting to prompt action by state officials and legislators. Some, including the head of California's state insurance exchange, say federal regulators should help assure consumers get the help and plans they need, especially during special enrollment periods when they lose jobs, move or have babies. (O'Donnell, 3/31)

Earlier, related KHN coverage: Licking Wounds, Insurers Accelerate

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