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KHN First Edition: May 16, 2016


First Edition

Monday, May 16, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Five Health Issues Presidential Candidates Aren’t Talking About — But Should Be
Kaiser Health News staff writer Julie Rovner reports: "References to the Affordable Care Act -- sometimes called Obamacare -- have been a regular feature of the current presidential campaign season. For months, Republican candidates have pledged to repeal it, while Democrat Hillary Clinton wants to build on it and Democrat Bernie Sanders wants to replace it with a government-funded “Medicare for All” program. But much of the policy discussion stops there. Yet the nation in the next few years faces many important decisions about health care -- most of which have little to do with the controversial federal health law. Here are five issues candidates should be discussing, but largely are not." (Rovner, 5/16)

Kaiser Health News: Fix For VA Health Snarls Veterans And Doctors In New Bureaucracy
Quil Lawrence, Eric Whitney and Michael Tomsic, in a partnership between Kaiser Health News, Montana Public Radio, WFAE and NPR, report: "Veterans are still waiting to see a doctor. Two years ago, vets were waiting a long time for care at Veterans Affairs clinics. At one facility in Phoenix, for example, veterans waited on average 115 days for an appointment. Adding insult to injury, some VA schedulers were told to falsify data to make it looks like the waits weren't that bad. The whole scandal ended up forcing the resignation of the VA secretary at the time, Eric Shinseki. Congress and the VA came up with a fix: Veterans Choice, a $10 billion program. Veterans received a card that was supposed to allow them to see a non-VA doctor if they were either more than 40 miles away from a VA facility or they were going to have to wait longer than 30 days for a VA provider to see them." (Lawrence, Whitney and Tomsic, 5/16)

The Wall Street Journal: Insurers’ Losses Deepened On ACA Plans In 2015
Many insurers have lost money on the Affordable Care Act plans they sell to consumers. A new analysis shows how much those losses deepened in 2015, the second year of the law’s signature exchanges. Based on insurers’ filings with state regulators, McKinsey & Co. estimates the health-insurance industry’s cumulative margin on individual plans last year was between -9% and -11%. That is roughly double the -4.8% margin the consulting firm calculated for 2014. For 2015, only about a quarter of insurers reported that they made a profit on their individual plans. (Wilde Mathews, 5/15)

The Wall Street Journal: Insurance Options Dwindle In Some Rural Regions
Health-insurance customers in a growing number of mostly rural regions will have just one insurer’s plans to choose from on the Affordable Care Act’s exchanges next year, as some companies pull out of unprofitable markets. The entire states of Alaska and Alabama are expected to have only one insurer on the health law’s signature online marketplaces next year, according to state regulators. The same is expected to be true in parts of several other states, including Kentucky, Tennessee, Mississippi, Arizona and Oklahoma, state regulators said. (Wilde Mathews and Armour, 5/15)

The Baltimore Sun: Health Insurers Seek Rate Increases In Maryland As United Healthcare Quits Market
The unanticipated costs of providing health care to customers on the state's online exchange has prompted large insurers to seek rate increases of up to 30 percent while one insurer decided not to offer individual plans at all. United Healthcare, the nation's largest insurer but a bit player in Maryland, was not included on a list released Friday by state regulators of companies seeking rate increases for 2017. Insurance Commissioner Al Redmer confirmed that the company was leaving the exchange created under the Affordable Care Act, as it has in most states across the country. It will continue to offer plans in the small-business market. (McDaniels and Cohn, 5/13)

The Washington Post: Obama Administration: Insurers Must Provide Services Regardless Of Gender Identity
The Obama administration unveiled two broad initiatives Friday aimed at combating discrimination against transgender Americans in schools and health-care coverage, affirming the president’s goal of elevating transgender protections to one of the central civil rights issues of his presidency. The moves, both of which had been in the works for years, prompted an immediate backlash from conservatives who disparaged the measures as government overreach. White House officials countered that they reflected one of the administration’s core principles: protecting those targeted for discrimination because of their identity. (Eilperin, 5/13)

USA Today: Feds: Insurers Can't Discriminate On LGBT Obamacare Coverage
Insurers and hospitals can't discriminate against patients because of their gender identity under the Affordable Care Act, federal officials said Friday, but patient groups complained the rule doesn't go far enough. The Department of Health and Human Services finalized a rule that prohibited discrimination in health care based on a long list of characteristics ranging from race to pregnancy, gender identity and "sex stereotyping." It doesn't mean insurers have to cover all treatments associated with gender transitioning but they just can't outright deny them either. But the rule doesn't go far enough in clarifying what is discrimination, some say. (O'Donnell, 5/13)

The Wall Street Journal: Obama Administration Extends Antibias Protections to Transgender People Seeking Health Care
The moves by multiple federal agencies broadened an emotional debate on the transgender issue, which escalated earlier this week when the Justice Department and the state of North Carolina sued each other over a new law in the state requiring people to use public bathrooms based on the gender on their birth certificates. “There is no room in our schools for discrimination of any kind, including discrimination against transgender students on the basis of their sex,” Attorney General Loretta E. Lynch said. (Barrett and Radnofsky, 5/13)

The Associated Press: In Surprising Turnabout, Oklahoma Eyes Medicaid Expansion
Despite bitter resistance in Oklahoma for years to President Barack Obama's health care overhaul, Republican leaders in this conservative state are now confronting something that alarms them even more: a huge $1.3 billion hole in the budget that threatens to do widespread damage to the state's health care system. So, in what would be the grandest about-face among rightward leaning states, Oklahoma is now moving toward a plan to expand its Medicaid program to bring in billions of federal dollars from President Obama's new health care system. (5/16)

The Washington Post: This Health-Care Trend Could Make Your Hospital Stay $2,000 More Expensive
Consolidation in the health-care industry is accelerating and has helped drive up prices in parts of the country, Edith Ramirez, chair of the Federal Trade Commission, said in a speech Friday. “I remain very concerned about the rapid rate of consolidation among health-care providers,” Ramirez said. Last year, the number of hospital mergers increased 18 percent compared with the previous year, she said. In areas where there is a hospital monopoly, prices are 15 percent higher than those in areas with four or more competitors, and the average in-patient stay in those places is almost $2,000 higher, Ramirez said. (Merle, 5/13)

The Associated Press: Storing Babies' Blood Samples Pits Privacy Versus Science
Two-day-old Ellie Bailey squirms in a hospital bassinet and cries as her tiny left heel is squeezed and then pricked with a needle to draw a blood sample. An Indianapolis hospital technician quickly saturates six circles on a special filter card with the child's blood. Ellie is among some 4 million newborns in the United States who will have blood drawn this year to screen them for serious inherited diseases such as sickle cell anemia, which can cause organ damage, and the metabolic disease phenylketonuria, or PKU, which can lead to mental disabilities. (5/13)

The New York Times: Puerto Rico Reports First Microcephaly Case Linked To Zika
A pregnant woman in Puerto Rico has become the first American whose fetus developed microcephaly because of a Zika infection acquired in the United States, the territory’s health department said on Friday. Dr. Ana Ríus, the island’s health secretary, said the fetus, which was not carried to term, had developed a shrunken skull and calcified spots in the brain, suggesting inflammation and cell death. (McNeil, 5/13)

The Washington Post: Puerto Rico Reports First Zika-Related Case Of Microcephaly
Puerto Rico is reporting its first Zika-related microcephaly case amid an outbreak of the mosquito-borne virus that has hit the commonwealth harder than anywhere else in the United States. In San Juan, Health Secretary Ana Rius told reporters Friday that a fetus turned over to U.S. health officials had severe microcephaly and tested positive for Zika. Rius declined to say whether the woman involved had an abortion or miscarried. A health department statement referred to a male fetus that showed "severe microcephaly and calcifications in the brain accompanied by Zika-wide presence of the virus." (Sun, 5/13)

The Associated Press: New York Diocese Sues To Rescind Insurer Abortion Mandate
The Roman Catholic Diocese of Albany has sued state insurance regulators over requirements that workplace health plans cover employee abortions. The Department of Financial Services lacks legislative authority to impose the requirements, and the mandate is unconstitutional, because it forces employers with religious and conscientious objections to abortion to help pay for them, according to the lawsuit filed in state court. (5/13)

Los Angeles Times: State Found Lapses In Infection Control At UCLA And Cedars
After "super bug" outbreaks last year involving a hard-to-clean medical scope, state health inspectors descended on two of Los Angeles’ largest hospitals and found numerous safety violations that appeared to put far more patients at risk. At UCLA Ronald Reagan Medical Center, the state declared an “immediate jeopardy” – meaning lives were at imminent risk – on March 4, 2015, after finding staff using contaminated water and a tainted liquid cleaner dispenser being used to ready colonoscopes and other devices for the next patients. (sen, 5/14)

The Wall Street Journal: Study Of Telemedicine Finds Misdiagnoses Of Skin Problems
Researchers posing as patients with skin problems sought help from 16 online telemedicine companies—with unsettling results. Some of the online doctors misdiagnosed syphilis, herpes and skin cancer, and some prescribed medications without asking key questions about patients’ medical histories or warning of adverse effects, the researchers found. Two sites linked users with doctors located overseas who aren’t licensed to practice where the patients were located, as required by state law. (Beck, 5/15)

The New York Times: The Improvisational Oncologist
The bone-marrow biopsy took about 20 minutes. It was 10 o’clock on an unusually chilly morning in New York in April, and Donna M., a self-possessed 78-year-old woman, had flown in from Chicago to see me in my office at Columbia University Medical Center. She had treated herself to orchestra seats for “The Humans” the night before, and was now waiting in the room as no one should be asked to wait: pants down, spine curled, knees lifted to her chest — a grown woman curled like a fetus. I snapped on sterile gloves while the nurse pulled out a bar cart containing a steel needle the length of an index finger. The rim of Donna’s pelvic bone was numbed with a pulse of anesthetic, and I drove the needle, as gently as I could, into the outer furl of bone. A corkscrew of pain spiraled through her body as the marrow was pulled, and then a few milliliters of red, bone-flecked sludge filled the syringe. It was slightly viscous, halfway between liquid and gel, like the crushed pulp of an overripe strawberry. (Mukherjee, 5/12)

The New York Times: The Cancer Almanac
In the midst of a genetic revolution that promises to scramble everything we know about cancer and how to treat it, our experience of the disease today still begins with a single question: Where did it start? That, it turns out, remains a very useful question to ask. The practice of categorizing cancer according to its point of origin within a specific organ or system grew from decades of steady discoveries made by researchers staring at stained slides under a microscope. The shape of cancer cells, they found, would often give clues about a cancer’s behavior. Broken down and sorted by appearance — some cells might be flatter, some are shaped like rings, some look more like oats — cancers were treated differently, and treatment improved. Even as doctors move to the precision of genetic research, the knowledge gained by staring at cells continues to be crucial to treatment. (Bradley, 5/12)

The Washington Post: Defective ‘Breast Cancer’ Genes Aren’t Just Dangerous For Women. They’re Also Linked To Aggressive Cancer In Men.
Joe Scholten’s sister had already beaten breast cancer and was battling ovarian cancer when she tested positive for a genetic mutation linked to both. He responded by doing something unusual: He got tested, too. That’s how the District resident discovered that he also carried the defective BRCA gene. He quickly told his brothers, other relatives and, hardest of all, his daughter. “Getting tested was a no-brainer,” he said, wondering what steps his sister would have taken if she’d learned early on about her own genetic risk. She was 54 when the ovarian cancer killed her. He realizes now that not knowing your medical pedigree is “clearly a danger.” (McGinley, 5/15)

The Associated Press: Bid To Raise California Tobacco Tax Nears November Ballot
A well-financed campaign whose backers include billionaire environmentalist Tom Steyer, medical groups and organized labor has collected enough signatures for a ballot measure to raise California's cigarette tax by $2 per pack, officials said. The Save Lives California coalition scheduled a news conference Monday at the San Diego County Registrar of Voters office to submit the first signatures in a campaign to nearly triple California's cigarette tax to $2.87 a pack. If enough signatures are verified, the measure would appear on an increasingly crowded Nov. 8 ballot. (5/16)

NPR: Suddenly Paralyzed, Two Men Struggle To Recover From Guillain-Barre
For Tim Goliver and Luther Glenn, the worst illness of their lives started in the same way — probably after having a stomach bug. Tim was 21 and a college student at the University of Michigan. He was majoring in English and biology and active in the Lutheran church. "I was a literature geek," says Tim. "I was really looking forward to my senior year and wherever life would take me." Luther was in his 50s. He'd spent most of his career as a U.S. military policeman and was working in security in Washington, D.C. (Bichell, 5/16)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2016 Kaiser Health News. All rights reserved.

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