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From Kaiser Health News:

Kaiser Health News Original Stories

3. Political Cartoon: 'Challenge Accepted?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Challenge Accepted?'" by Mike s.

Here's today's health policy haiku:


Medicare now pays
Docs to discuss end-of-life
Care, but not trained to.

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Summaries Of The News:

Health Law Issues And Implementation

4. Analysis: Health Law Has Halted Decades-Long Expansion Of The Gap Between Haves And Have-Nots

The New York Times offers analysis of coverage gains under the Affordable Care Act. In other news, UnitedHealth has announced it will be pulling out of the Michigan exchange, an announcement that comes on the heels of its decision to withdraw from Georgia and Arkansas.

The New York Times: Immigrants, The Poor And Minorities Gain Sharply Under Health Act
The first full year of the Affordable Care Act brought historic increases in coverage for low-wage workers and others who have long been left out of the health care system, a New York Times analysis has found. Immigrants of all backgrounds — including more than a million legal residents who are not citizens — had the sharpest rise in coverage rates. Hispanics, a coveted group of voters this election year, accounted for nearly a third of the increase in adults with insurance. That was the single largest share of any racial or ethnic group, far greater than their 17 percent share of the population. (Tavernise and Gebeloff, 4/17)

The Wall Street Journal: UnitedHealth To Stop Offering Affordable Care Act Plans In Michigan In 2017
UnitedHealth Group Inc. will stop offering Affordable Care Act plans in Michigan in 2017, marking the third in a growing tally of states where the biggest U.S. insurer will withdraw from the health law’s marketplaces. Andrea Miller, a spokeswoman for the Michigan Department of Insurance and Financial Services, said the insurer planned to pull out of the individual insurance market in the state. Regulators in Arkansas and Georgia earlier said UnitedHealth had informed them it would no longer sell the ACA plans in their states. (Wilde Mathews, 4/15)

Meanwhile, a look at where the remaining Republican presidential candidates stand on the health law and other issues —

McClatchy: How GOP Presidential Candidates Compare On Health Care Issues
Six years after the passage of the Affordable Care Act, “Obamacare,” the nation’s health care remains at the center of political debate. Here’s a look at how the three remaining Republican presidential candidates view Obamacare, the cost of prescription drugs, the role of Medicare and Medicaid in confronting the nation’s provision of medical services, and abortion. (Douglas and Recio, 4/17)

5. Ark. Governor Hopes To Save Medicaid Expansion With Veto Strategy

As the state Senate balks at funding the expanded program, Gov. Asa Hutchinson is betting that he can use the line item veto to keep it running. Also, news outlets examine Medicaid expansion news in Ohio and New Hampshire.

Arkansas News: Supporters Of Medicaid Plan Asked To Vote Against It To Save It
The state Legislature’s fiscal session hit a snag on its second day last week, and the leading strategy that has emerged for resolving that snag is somewhat counter-intuitive. In a nutshell, supporters of Gov. Asa Hutchinson’s plan to continue and modify Arkansas’ Medicaid expansion program are being asked to vote against funding the plan to save it. (Lyon, 4/17)

The Associated Press: Governor Defends Line-Item Veto Plan For Medicaid Expansion
Gov. Asa Hutchinson says a plan aimed at allowing him to reinstate Arkansas' hybrid Medicaid expansion if it's defunded is the best chance lawmakers have at quickly resolving a budget standoff over the program. The Republican governor on Friday defended a plan to add a provision to Medicaid's budget that would defund the expansion, which uses federal funds to purchase private insurance for the poor. Hutchinson has said he'll veto that provision if the bill is approved by the Legislature, which would then allow the Legislature to effectively fund the program with a simple majority by upholding his veto. (DeMillo, 4/15)

Arkansas Democrat Gazette: Medicaid Strategy Faces Test In Session's Gridlock
After a four-day break, the Republican-dominated Legislature on Tuesday will resume tackling whether to proceed with Gov. Asa Hutchinson's line-item veto strategy as a means to allow the use of federal Medicaid funds to purchase private health insurance for low-income Arkansans in the next fiscal year. ... the Senate on Thursday failed to pass the state Department of Human Services' Medical Services Division appropriation as is, with the private-option funding intact. (Wickline, 4/17)

The Cleveland Plain Dealer: Public Debate Opens On Proposal To Make Ohio Medicaid Recipients Pay For Care
Gov. John Kasich's administration today filed a detailed draft of changes to the state's Medicaid program, kicking off public debate over a requirement that beneficiaries make monthly payments or lose their coverage. ... The proposal is already fueling a fiery debate in communities statewide. Supporters say it injects needed personal responsibility into the program and will help pare Medicaid's ever-rising costs. Opponents argue it undermines recent progress in expanding access to Medicaid and will erect a cost barrier in front of people who can least afford it. (Ross, 4/15)


6. Trying To Save Medicare: CMS Innovation Center Experiments With New Practices

The Associated Press examines the group of doctors, lawyers, health policy experts and career federal employees charged with coming up with ways to save money and improve care in Medicare. Meanwhile, news outlets report on other Medicare developments including bundled payments, hospice use and fraud.

The Associated Press: 'Innovation Center' Tries To Reinvent Medicare
They work for the government and even their closest relatives have no idea what they do. It's not because they're spies or nuclear scientists, but because their jobs are so arcane: trying to reinvent Medicare to improve it, and maybe save taxpayers money. In a sprawling, nondescript office park near Baltimore, some 360 people at the Center for Medicare & Medicaid Innovation are trying to change the health care system, using the government's premier insurance program as leverage. (Alonso-Zaldivar, 4/18)

The Milwaukee Journal-Sentinel: Can Fixed Payments Transform The Health Care Industry?
More than 1 million people, including more than 400,000 covered by Medicare, have surgery to replace a knee or hip each year. Medicare alone spent more than $7 billion just for hospital care in 2014, according to the Centers for Medicare and Medicaid Services. At the same time, the quality and total cost of surgery varies significantly, with the rate of complications at some hospitals more than three times higher than the best-performing hospitals and the total cost to Medicare ranging from $16,500 to $33,000. ... Meriter [hospital it Milwaukee], which does about 700 knee and hip replacements a year, lowered costs while improving the quality of care, based on metrics such as readmissions, infections, pain and movement. But it also had a strong incentive to provide better care: Complications meant the difference between making money and losing money. (Boulton, 4/16)

Sun-Times Wire: Chicago Couple Accused Of $45M Medicare Fraud, Forced Labor
A Chicago couple accused of participating in a Medicare fraud scheme that swindled the government out of $45 million has also been charged with planning to force a Filipino woman to work as their nanny and housekeeper against her will. Richard Tinimbang, 38, and his wife, 40-year-old Maribel Tinimbang, both face one count of conspiracy to defraud Medicare, one count of money laundering conspiracy and one count of conspiracy to obtain forced labor, according to a statement from the U.S. Attorney’s office. (4/17)


7. Immunotherapy Drug Doubles Long-Term Survival Rate For Melanoma Patients

Opdivo is a checkpoint inhibitor, which releases the break on the immune system allowing a patient's body to fight the cancer. Research released on Sunday shows that patients who received the drug had a 34 percent survival rate 5 years out. A similar immunotherapy drug, Keytruda, was part of Jimmy Carter's successful treatment for advanced melanoma.

The Washington Post: Long-Term Survival Rates Double For Melanoma Patients Getting Immunotherapy
More than a third of advanced-melanoma patients who received one of the new immunotherapy drugs in an early trial were alive five years after starting treatment -- double the survival rate typical of the disease, according to a new study. The data, released Sunday at a cancer conference, showed that 34 percent of patients with metastatic melanoma who received Opdivo, an immunotherapy drug also known as nivolumab, have survived. The five-year survival rate for patients with advanced melanoma who got other treatments was 16.6 percent between 2005 and 2011, according to the National Cancer Institute. ... Doctors used (a similar) immunotherapy drug Keytruda, along with radiation, to treat former president Jimmy Carter. (McGinley, 4/17)