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4. Political Cartoon: 'Close The Books'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Close The Books'" by Gary McCoy.

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Summaries Of The News:

Health Law Issues And Implementation

5. After UnitedHealth's Exit, What's Next For Health Exchanges?

News outlets break down how consumers might be affected by the insurer's decision to leave the health law marketplaces. Meanwhile, the Connecticut Mirror details how its state health exchange, Access Health CT, might take on a broader role in the future.

CBS News: Orphaned By UnitedHealth? Here's What You Can Do
UnitedHealth Group (UNH) CEO Stephen Hemsley's announcement on Tuesday -- saying the insurance company would leave all but a handful of state health care exchanges by 2017 -- sparked plenty of the usual debate about the viability of the Affordable Care Act and whether insurers can make money in the exchanges. But for the 795,000 patients who pay for UnitedHealth coverage through an exchange, the most pressing question is, "What do I do now?" (Konrad, 4/21)

And The Fiscal Times looks ahead to 2017 premiums —

6. Arkansas Legislature's And Governor's Maneuvers Extend Medicaid Expansion

The Arkansas House sent Gov. Asa Hutchinson a bill Thursday that would have ended funding at the end of the year knowing the governor planned to veto that provision, which he promptly did. The legislation now allows the program to continue.

The Associated Press: Arkansas GOP Governor Uses Veto To Save Medicaid Program
Gov. Asa Hutchinson on Thursday effectively saved Arkansas' first-in-the-nation hybrid Medicaid expansion by voiding part of a budget bill that would have ended the subsidized insurance for more than 250,000 poor people. The Republican governor vetoed a provision in the Medicaid budget that ordered a Dec. 31 end to the program, which uses federal funds to purchase private insurance for the poor. (DeMillo, 4/21)

Arkansas News: Arkansas Works Funding Gets House OK, Governor’s Signature
The House approved Senate Bill 121, a bill to fund Arkansas Works and other Medicaid programs for the coming fiscal year, in a 76-13 vote a day after the Senate approved it in a 27-12 vote. Like most appropriation bills, the measure needed a three-fourths majority vote in each chamber to pass, or 75 votes in the House and 27 in the Senate. Before signing the bill, Hutchinson used his line-item veto power to veto a provision that would have required the program to end Dec. 31 of this year. (Lyon, 4/21)

KUAR (Arkansas Public Radio): Governor Hutchinson Uses Veto Plan To Continue Arkansas's Medicaid Expansion
While the Republican governor says Medicaid expansion will now continue, Senate President Jonathan Dismang and other backers are considering additional legislation to safeguard against legal challenges to their procedural move. Speaking to reporters after a taping of AETN's Arkansas Week, the Republican from Searcy said a measure could be adopted in a future special session to re-state the 2021 expiration date for Arkansas Works, that the governor puts back in place with his veto. (Hickey and Kaufman, 4/21)

Kaiser Health News: Using Novel Line-Item Veto, Ark. Governor Extends Medicaid Expansion
The Medicaid expansion covers more than 267,000 Arkansans who make less than 138 percent of the federal poverty level (about $16,000 for an individual or a little more than $33,000 for a family of four). The expansion came from a 2013 compromise between Republican lawmakers and Democratic Gov. Mike Beebe. It became known as the “private option” because the state received a federal waiver to use Medicaid funds to purchase private health insurance plans for most newly eligible beneficiaries. (Ramsey, 4/21)

Arkansas Democrat-Gazette: Medicaid-Bill Ploy On Track
Hutchinson advocated the line-item strategy so the expansion's opponents could vote for a bill that ended the funding. Later that afternoon, Hutchinson made good on his promise and vetoed that portion of the bill, which will now go back to the Senate, where only a simple majority is needed to uphold or overturn a veto. (Wickline and Willems, 4/22)

Public Health And Education

7. Suicide Rate In U.S. Spikes To Highest Levels In Nearly 3 Decades

From 1999 to 2014, the overall rate increased by 24 percent, while middle-aged women saw a sharp uptick of 63 percent. Meanwhile, the number of suicides for girls aged 10 to 14 tripled.

The New York Times: U.S. Suicide Rate Surges To A 30-Year High
Suicide in the United States has surged to the highest levels in nearly 30 years, a federal data analysis has found, with increases in every age group except older adults. The rise was particularly steep for women. It was also substantial among middle-aged Americans, sending a signal of deep anguish from a group whose suicide rates had been stable or falling since the 1950s. The suicide rate for middle-aged women, ages 45 to 64, jumped by 63 percent over the period of the study, while it rose by 43 percent for men in that age range, the sharpest increase for males of any age. The overall suicide rate rose by 24 percent from 1999 to 2014, according to the National Center for Health Statistics, which released the study on Friday. (Tavernise, 4/22)

The Washington Post: U.S. Suicide Rate Has Risen Sharply In The 21st Century
Last decade’s severe recession, more drug addiction, “gray divorce,” increased social isolation, and even the rise of the Internet and social media may have contributed to the growth in suicide, according to a variety of people who study the issue. But economic distress — and dashed hopes generally — may underpin some of the increase, particularly for middle-aged white people. The data showed a 1 percent annual increase in suicide between 1999 and 2006 but a 2 percent yearly hike after that, as the economy deteriorated, unemployment skyrocketed and millions lost their homes. (Keating and Bernstein, 4/22)

The Wall Street Journal: Suicides In The U.S. Climb After Years Of Declines
While more men kill themselves than women, the suicide rate for women rose faster between 1999 and 2014 than it did for men. “It narrowed the gap,” said Sally Curtin, a statistician at the CDC’s National Center for Health Statistics and an author of the report. The report showed a surge in suicides among middle-age men and women, a factor noted in rising death rates among middle-aged people and a decline in white Americans’ life expectancy in 2014. The suicide rate for white women ages 45 to 64 rose 80% and for white men of that age group 59% between 1999 and 2014, according to a second CDC report released on Friday. There were increases in the suicide rate of every age group for both sexes except those 75 and older. That includes a startling tripling in the suicide rate for the youngest girls, ages 5 to 14. (McKay, 4/22)

Los Angeles Times: U.S. Suicides Have Soared Since 1999, CDC Report Says
All told, some 42,773 Americans died of suicide in 2014, according to the Centers for Disease Control and Prevention. That made suicide the 10th leading cause of death for all ages. "This is definitely harrowing: The overall massiveness of the increase is to me the biggest shocker--the fact that it touched pretty much every group," said Katherine A. Hempstead, who recently published an analysis of U.S. suicide trends in the American Journal of Preventive Medicine. (Healy, 4/21)