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In This Edition:

From Kaiser Health News:

Kaiser Health News Original Stories

4. Political Cartoon: 'Fly The Coop'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Fly The Coop'" by R.J. Matson, Roll Call.

Here's today's health policy haiku:


A luxury service for
the worried wealthy?

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Summaries Of The News:

Health Law Issues And Implementation

5. Will Federal Officials Practice What They Preach Over Aggressive Insurance Rate Reviews?

Four states — Missouri, Oklahoma, Texas and Wyoming — have left it up to the federal government to review rate increases. And while officials have urged states to take a firm stance on unwarranted spikes, it is unclear if they will significantly pare back rates themselves. In other news, the calls to "repeal and replace" the health law grow shakier now that so many Americans are covered.

The New York Times: Insurers, Pushing For Higher Rates, Challenge Key Component Of Health Law
For several years, the Obama administration has urged state insurance regulators to use tools provided by the Affordable Care Act to hold down health care premiums. Now federal officials will have a chance to practice what they preach as they confront big increases proposed in several states where they are responsible for reviewing rates. Federal officials defer to the insurance commissioners in 46 states deemed to have “effective rate review” programs. But in Missouri, Oklahoma, Texas and Wyoming, the federal government is in charge of reviewing rates. (Pear, 7/16)

The Associated Press: With Millions Covered,' Repeal And Replace' Gets Riskier
Cleveland, we have a problem. As Republicans gather to anoint their presidential ticket, Donald Trump's plan for replacing "Obamacare" appears to be anything but solid. A nonpartisan analysis recently found it would make 18 million people uninsured. ... "I don't think they can credibly do 'repeal' until they have a solid legislative proposal to replace it," said Lanhee Chen, policy director for the 2012 Mitt Romney presidential campaign. "Politically, you can't really do 'repeal' without the 'replace' coming in right behind it." Trump "has made some vague pronouncements, but that's not a plan," he added. Many conservatives are hoping House Speaker Paul Ryan, R-Wis., will have the answer. (Alonso-Zaldivar, 7/18)

Meanwhile, Medicare's program testing accountable care organizations faces hurdles as participants withdraw, and a look at why co-ops are struggling —

Modern Healthcare: Three ACOs Bail On Medicare's Next Generation Program
Medicare's newest program testing accountable care organizations is not even a year old, and three out of 21 participants have already exited. ... The remaining 18 are still within the range of 15-20 ACOs CMS officials thought would participate. But the exiting parties indicate Medicare's payment reforms, which center around quality and the ability to keep costs down, still have not completely won over many hospitals and doctors. (Herman, 7/15)

St. Louis Post-Dispatch: Why Land Of Lincoln And Other Health Insurance Co-Ops Failed
Failures among member-run health insurance co-ops are forcing thousands of consumers to find new health insurance coverage, while renewing questions about the viability of a once-promising program created by the Affordable Care Act. In Illinois, about 49,000 people must find coverage after state regulators last week ordered Land of Lincoln Mutual Health Insurance Co. to close in the face of steep losses. (Liss, 7/17)

6. After Failed Attempts To Expand Medicaid, Tennessee Weighing Different Options

The two-pronged plan, which grew out of legislative task force meetings around the state, would first expand coverage to low-income residents with mental health issues and to veterans. Also in the news, Medicaid expansion proves more popular than expected in Ohio and Montana.

The Tennessean: How Is New TN Medicaid Expansion Plan Different?
The newest plan, the product of House Speaker Beth Harwell’s 3-Star Healthy Task Force, prioritizes veterans and those with mental health needs. However, in order to be enacted, it needs both federal approval from the Centers for Medicare and Medicaid Services and state approval from the legislature. (Tolbert, 7/17)

Kaiser Health News: Montana Medicaid Expansion By-The-Numbers
Backers of Montana’s seven-month-old Medicaid expansion say they’re pleased with the first set of financial data released this week. State figures say enrollment as of July is nearly double initial projections, at 47,399 of the 25,000 who were expected to enroll by now. And there’s still room to grow: 59,000 Montanans are estimated to be eligible for Medicaid expansion, according to state officials. (Whitney, 7/18)

Campaign 2016

7. Pence's Unwavering Crusade Against Abortion And What It Means For Trump

By picking Mike Pence, Donald Trump adds a social-issues warrior with a very conservative track record to his ticket. Pence's unbending stance on abortion rights may hurt Trump's support among women and help with anti-abortion voters.

The New York Times: How Mike Pence Became A Conservative Hero: Unwavering Opposition To Abortion
One by one, Republican women of the Indiana state legislature rose to describe, in anguished terms, why they could not support an anti-abortion measure hurtling toward passage. They hated abortion, they said, but this bill went too far. It would have prohibited a woman from aborting a fetus because it had a disability, such as Down syndrome. ...Indiana’s governor, Mike Pence, waved off the objections of his fellow Republicans: He signed the legislation into law a few weeks later, enacting what advocates and foes agree was a sweeping and unusual set of restrictions on abortion that went further than any other state in the country and openly clashed with legal precedent. (Davey and Barbaro, 7/16)

The Washington Post: Mike Pence Has Made No Secret About His Views On Abortion. Will This Help Or Hurt Trump?
Donald Trump just announced Indiana Gov. Mike Pence as his VP running mate. If the name sounds familiar, even if you haven't been paying attention to the days of speculation about the pick, it's probably because of Pence's work regarding women's reproductive rights. The Republican first made national headlines on this subject in 2011 when, as a representative to Congress from his state's 2nd District, he sought to defund Planned Parenthood because it provides abortions. Until that time, the women's health organization had made it through numerous GOP Congresses and never become such a big target. (Cha, 7/15)

The Washington Post: Trump Has A Problem With Female Voters. Pence Could Make It Even Worse.
Donald Trump has already had problems making inroads with female, gay and minority voters. His vice-presidential pick, Indiana Gov. Mike Pence, could make things even worse. Pence, the Republican governor of Indiana, has endorsed conservative legislation on abortion, gay rights and immigration both in his home state and while in Congress, where he was consistently ranked as one of the most right-leaning members of the House. He attempted to shut down the government over Planned Parenthood funding, supported a measure that made English the nation’s official language and signed one of the nation’s strictest abortion laws earlier this year. (Zezima, 7/16)

Stat: Women Are Calling Donald Trump’s Campaign To Report On Their Periods
One Utah woman called Donald Trump’s presidential campaign on Friday with a question: Where should she send her used tampons in case of a miscarriage? An Indiana woman called with a different query: Could she go swimming, or would the chlorine in the water be harmful to her unfertilized eggs? And a Colorado woman had a message for the campaign: She may have lost a couple hundred eggs just today. The flood of calls, reported in comments on Facebook, are part of a social media push started by women in Indiana opposed to a restrictive abortion law passed earlier this year in Indiana that required the remains of a miscarried or aborted fetus to be buried or cremated. In April, women began calling Governor Mike Pence’s office in protest. Now, with Trump’s announcement he has chosen Pence as his running mate, the “Periods for Pence” push is going national. (Robbins, 7/15)

Politico Pro: Pence Plugs Enthusiasm Gap For Anti-Abortion Voters
Donald Trump’s selection of Gov. Mike Pence as his running mate could finally make anti-abortion voters excited to vote for the Republican ticket. Pence’s long record of opposition to abortion has energized anti-abortion voters in a way that Trump has not. Pence wrote a bill to defund Planned Parenthood and other family planning clinics nearly a decade ago — long before it became a GOP policy staple — and he has signed numerous restrictions into state law. That gives anti-abortion voters confidence that Trump will be a champion of causes that matter most to them. (Haberkorn, 7/15)