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KHN First Edition: August 12, 2016


First Edition

Friday, August 12, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Should Big Insurance Become Like Walmart To Lower Health Costs?
Kaiser Health News staff writer Jay Hancock reports: "Retail titan Walmart uses its market dominance to inflict “ruthless,” “brutal” and “relentless” pressure on prices charged by suppliers, business writers frequently report. What if huge health insurance companies could push down prices charged by hospitals and doctors in the same way? The idea is getting new attention as already painful health costs accelerate and major medical insurers seek to merge into three enormous firms." (Hancock, 8/11)

Kaiser Health News: Administration Paints Rosy Future For Obamacare Marketplaces
Kaiser Health News staff writer Phil Galewitz: "Despite dire warnings from Republicans and some large insurers about the stability of the Affordable Care Act exchanges, an Obama administration report released Thursday indicated the individual health insurance market has steadily added healthier and lower-risk consumers. Medical costs per enrollee in the exchanges in 2015 were unchanged compared with 2014, according to the Centers for Medicare & Medicaid Services. In contrast, per-member health costs rose between 3 percent and 6 percent in the broader U.S. insurance market, which includes 154 million people who get coverage through their employer and the 55 million people on Medicare, the report said." (Galewitz, 8/11)

Kaiser Health News: More Small, Midsized Firms Choose To Pay Workers’ Medical Costs Directly
Kaiser Health News consumer columnist Michelle Andrews reports: "Instead of buying a health insurance policy to cover their workers, a growing number of small and midsized companies are opting to pay their employees’ medical claims directly, a potentially riskier practice financially called self-insuring, a recent study found. Between 2013 and 2015, the proportion of midsized companies with 100 to 499 employees that were self-insured increased 19 percent, to 30.1 percent, according to the analysis published in July by the Employee Benefit Research Institute. The percentage of small firms with fewer than 100 employees that self-funded their health plans grew 7 percent, to 14.2 percent, the study found. Meanwhile, self-funding by large companies declined slightly, to 80.4 percent." (Andrews, 8/12)

Kaiser Health News: Researchers Identify A Key Weapon Of Zika Virus
Carmen Heredia Rodriguez, for Kaiser Health News, reports: "Scientists at the University of Southern California discovered a key weapon used by the Zika virus to ravage the brains of infected fetuses: proteins. In an article published Thursday in the journal Cell Stem Cell, researchers identified two proteins in Zika potentially responsible for causing microcephaly. ... The proteins — called NS4A and NS4B — affect the brain by targeting a critical signaling pathway that controls cell growth and breaks down damaged cells and their elements. Initially, Zika slows cell development and reduces the variety of cells in the brain. Over time, this “rigged” system enables the virus to thrive and spread while healthy cells die." (Heredia Rodriguez, 8/11)

California Healthline: Licensing Logjam For California Nurses
Eryn Brown, for California Healthline, reports: "Ivana Russo submitted her application for a California nursing license on April 22, nearly a month before she graduated from a nursing program at Brightwood College in San Diego. She expected it to take 10 to 12 weeks for the state to process her paperwork and authorize her to take the licensing exam. As of early August, 15 weeks later, the licensing board still had not reviewed her file and could not tell her when it would. Russo called the agency, often, to ask about the status of her application. It was hard to get a staff member on the phone. When she did, she said, “Every time I got a different story.” (Brown, 8/11)

The Wall Street Journal: Obama Administration Counters Insurer View On Healthcare Law’s Costs
The Obama administration on Thursday issued a data analysis saying insurers’ costs for people who buy health-care coverage on their own remained essentially the same between the first and second years of the Affordable Care Act, partly because of a healthier mix of customers on exchanges created by the law. The analysis is one way the administration is seeking to counter insurers seeking substantial premium increases for 2017. Health insurers already have filed proposed rates for the year ahead with state regulators, and big plans across the country are seeking hefty premium increases because of what they say are substantial losses in the first few years of the law’s implementation. (Radnofsky, 8/11)

The Associated Press: Medicaid Estimate Renews Cost Concerns Over 'Obamacare'
A government report says the cost of expanding Medicaid to millions more low-income people is increasing faster than expected. That's raising questions about a vital part of President Barack Obama's health care law. The law called for the federal government to pay the entire cost of the Medicaid expansion from 2014 through the end of this year. (8/12)

The New York Times: With Congress Deadlocked, White House Diverts Funds To Fight Zika
The Obama administration on Thursday said it was shifting $81 million away from biomedical research and antipoverty and health care programs to pay for the development of a Zika vaccine, resorting to extraordinary measures because Congress has failed to approve new funding to combat the virus. Sylvia Mathews Burwell, the secretary of health and human services, told members of Congress in a letter that without the diverted funds, the National Institutes of Health and the Biomedical Advanced Research and Development Authority would run out of money to confront the mosquito-borne illness by the end of the month. (Davis, 8/11)

The Washington Post: Obama Administration To Shift $81 Million To Fight Zika
The money will supplement the $347 million HHS transferred away from an existing fund to fight the Ebola virus. The administration is seeking $1.9 billion to fight Zika, but Congress is deadlocked over the funding. “The failure to pass a Zika emergency supplemental has forced the Administration to choose between delaying critical vaccine development work and raiding other worthy government programs to temporarily avoid these delays,” Burwell wrote. (Snell and Dennis, 8/11)

The Wall Street Journal: New Zika Funding To Come From Inside NIH
Secretary Burwell, in her letter, said the administration now has to “choose between delaying critical vaccine development work and raiding other worthy government programs to temporarily avoid” delays in vaccine research on Zika. She estimated that, even with the $34 million, NIH will need another $196 million in fiscal 2017 for vaccine and other research related to Zika. (Burton and McWhirter, 8/11)

Politico: Administration Shifts More Funds To Zika Fight
NIAID Director Tony Fauci said at the National Press Club that funding Zika this way is not wise. "All of that is extremely damaging to the biomedical enterprise," he said. "We're taking money away from cancer, diabetes, all of those kinds of things." The new Zika funding is coming from other NIH accounts, as well as the Administration for Children and Families, CMS and the Substance Abuse and Mental Health Services Administration. Burwell said that these moves will “exhaust” the ability to provide short-term financing help for ZIka and that more funding will be needed. (Haberkorn, 8/11)

The Washington Post: Lobbyists Leading The Charge On Zika Funding: ‘We’re Making Stone Soup.’
Perhaps no one is more frustrated with Congress’s inaction on emergency Zika funding than Cindy Pellegrini. Pellegrini oversees lobbying at the March of Dimes, the nonprofit working to improve maternal and infant health. Since March, Pellegrini has been leading the charge on Capitol Hill to pass legislation funding research, vaccine development and other measures to combat the Zika virus, which causes severe brain defects in babies whose mothers are infected while pregnant. But her efforts have hit a wall. (Ho, 8/11)

The Wall Street Journal: Biotech’s Resurgence May Cost Big Pharma
There are signs that a new wave of deals is brewing in the biotech sector. That is juicing shares and pushing up valuations. Some likely buyers are Amgen, Gilead Sciences, and Merck, which are among the large drugmakers who have said this year that they are on the hunt for deals. Among possible sellers are Medivation, which signed confidentiality agreements with several potential acquirers earlier this summer, a precursor to a possible sale. The Wall Street Journal reported earlier this month that the biotech giant Biogen has attracted preliminary interest from at least two potential suitors. (Grant, 8/11)

The Washington Post: Do The New Merck HPV Ads Guilt-Trip Parents Or Tell Hard Truths? Both.
Merck, which is running its first television commercials on human papillomavirus (HPV) in half a dozen years, has ignited a fierce debate over whether the pharmaceutical giant is trying to "shame" parents into getting their children vaccinated for the most common sexually transmitted infection. The ads, which first aired June 28, are running on major network and cable channels, in day time and prime time, including during the Olympics, when a lot of people are watching TV with their families. They don't mention Merck's Gardasil, the most widely used vaccine for HPV. Instead, they take aim at a tender spot: parents' worries about doing right by their kids. (McGinley, 8/11)

Politico: Missouri PDMP: Quaint Outlier, Or Harbinger Of Privacy Backlash?
When officials try to explain why Missouri, alone among 50 states, has failed to create a monitoring program that tells doctors when patients are abusing narcotics, they point to a right-wing state senator who has repeatedly filibustered the program. The effort to block the program is championed by Rob Schaaf, a Republican family doctor who has intense worries about privacy — even going so far as to suggest the Pentagon is using health care databases to find out who has guns. (Tahir, 8/11)

The Associated Press: Studies Shine Light On Mysterious Placenta, How It Goes Awry
Scientists carefully probe a placenta donated after birth, bluish umbilical cord still attached. This is the body's most mysterious organ, and inside lie clues about how it gives life — and how it can go awry, leading to stillbirth, preterm birth, even infections like the Zika virus, that somehow sneak past its protective barrier. In labs around the country, major research is underway to finally understand and monitor this floppy, bloody tissue that's often dismissed as the "afterbirth," the organ that lives about nine months and then gets thrown away. (8/12)

The New York Times: De Blasio Signs Bill Mandating Lactation Rooms In City Offices
A new bill signed by Mayor Bill de Blasio on Thursday will require certain city offices and service centers to provide a lactation room for nursing mothers to use at their choosing. In a news conference on Thursday, Mr. de Blasio — surrounded by several women holding babies — trumpeted New York as “one of the first cities in the country” to pass such a bill. Other cities with similar legislation include Philadelphia, Pittsburgh and Madison, Wis. (Schmidt, 8/11)

The Associated Press: Justice Department Sues Mississippi Over Mental Health Care
The U.S. Justice Department sued Mississippi on Thursday, saying the state is violating the Americans With Disabilities Act by "unnecessarily and illegally" making mentally ill people go into state-run psychiatric hospitals. The state has failed to provide community-based services that would enable people with mental illnesses to have meaningful interaction with friends and family and to make decisions about work and daily life, says the suit filed Thursday in U.S. District Court in Jackson. It also says life in an institution leads to stigma, isolation and learned helplessness. (8/11)

The Wall Street Journal: Training Rikers Island Staff To Defuse Conflicts With Mentally Ill Inmates
Jenna banged her fists against a cinder-block wall at Rikers Island while two correction officers and a therapist hovered nearby. “I have the power, you do not!” screamed Jenna as she paced wildly in her cell. Jenna is actually Erin Shields, one of the actors who regularly come to the New York City jail complex, change into orange prison-uniform pants and play the role of inmate to teach correction and health staff how to defuse conflicts with the mentally ill. (Ramey, 8/11)

The Associated Press: Terminally Ill Woman Holds Party Before Ending Her Life
In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: “These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.” And just one rule: No crying in front of her.The 41-year-old artist with ALS, or Lou Gehrig’s disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state’s new doctor-assisted suicide law for the terminally ill. (Watson, 8/11)

NPR: Where Lead Lurks And Why Even Small Amounts Matter
Lead problems with the water in Flint, Mich., have prompted people across the country to ask whether they or their families have been exposed to the toxic metal in their drinking water, too. When it comes to assessing the risk, it's important to look in the right places.Even when municipal water systems' lead levels are considered perfectly fine by federal standards, the metal can leach into tap water from lead plumbing. (Pupovac, 8/12)

NPR: Long-Term Therapy Appeared To Rebuild Damaged Spinal Connections
Researchers in Brazil who are trying to help people with spine injuries gain mobility have made a surprising discovery: Injured people doing brain training while interacting with robot-like machines were able to regain some sensation and movement. The findings, published in Scientific Reports (one of the Nature journals), suggest that damaged spinal tissue in some people with paraplegia can be retrained to a certain extent — somewhat the way certain people can regain some brain function following stroke though repetition and practice. In fact, this isn't a new idea for treating injuries of the spinal cord. Even people with severe injuries can regain some sensation and function through physical therapy if some nerve fibers remain. (Harris, 8/11)

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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