In This Edition:

From Kaiser Health News:

Kaiser Health News Original Stories

1. Hospital Surprise: Medicare's Observation Care

You're in a hospital and think you're admitted. Maybe not. Many Medicare beneficiaries are surprised to learn that even after spending a couple of days, they are receiving observation care, which Medicare considers an outpatient service, so the seniors' costs can be more than expected. (Francis Ying and Thu Nguyen and Lynne Shallcross, 8/29)

4. Teaching Medical Teamwork Right From The Start

In a joint project, the Cleveland Clinic and Case Western Reserve University are banking on a new building to kick start efforts to bring health professionals together by introducing collaboration into medical training. (Julie Rovner, 8/29)

6. Political Cartoon: 'Pocket Change'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Pocket Change'" by Ann Telnaes.

Here's today's health policy haiku:

ANOTHER ONE DECIDES TO LEAVE ...

Marketplace trouble
Now Oscar's leaving two states
A recurring theme

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law Issues And Implementation

7. Threat Of Monopolies Looms As Insurers Withdraw From ACA Markets, Analysis Shows

More than 60 percent of counties in the United States could have only one or two options for coverage in 2017, according to a new analysis.

The Wall Street Journal: Health Insurers’ Pullback Threatens To Create Monopolies
Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law. The new study, by the nonpartisan Kaiser Family Foundation, suggests there could be just one option for coverage in 31% of counties in 2017, and there might be only two in another 31%. That would give exchange customers in large swaths of the U.S. far less choice than they had this year, when 7% of counties had one insurer and 29% had two. (Wilde Mathews and Armour, 8/28)

Reuters: More U.S. Counties To See Obamacare Marketplace Monopoly: Analysis
Nearly a third of U.S. counties will likely be served by only one insurer that participates in an Affordable Care Act (ACA) marketplace in 2017, according to an analysis published Sunday by the Kaiser Family Foundation.The 31 percent of U.S. counties that will have just a single option of insurers within the ACA's exchanges would represent an increase from 7 percent this year, the nonpartisan group found. (Hunnicutt, 8/27)

Meanwhile, enrollment numbers are significantly lower than predicted, and Tennessee Sen. Lamar Alexander rails against the health law —

The Washington Post: Health-Care Exchange Sign-Ups Fall Far Short Of Forecasts
Enrollment in the insurance exchanges for President Obama’s signature health-care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses. As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation. (Johnson, 8/27)

The Hill: Tenn. Senator Blasts 'Intolerable Increase' In ObamaCare Prices 
Sen. Lamar Alexander (R-Tenn.) on Saturday said his state offers living proof ObamaCare is on its last legs.“When Tennesseans woke up on Wednesday morning and opened up our state’s largest newspaper, the front page headline read, ‘Very near collapse,’” he said in the GOP’s weekly address. (Hensch, 8/27)

Administration News

8. FDA: All Donated Blood Should Be Screened For Zika

The agency -- in an effort to safeguard the nation's blood supply -- says even centers in states where Zika is not circulating should take precautions. Meanwhile, the Obama administration is warning that all funding will be exhausted by the end of September.

The New York Times: All Donated Blood In U.S. Should Be Tested For Zika, F.D.A. Says
The Food and Drug Administration on Friday took steps to safeguard the nation’s blood supply from the Zika virus, calling for all blood banks to screen donations for the infection even in states where the virus is not circulating. The recommendations are an acknowledgment that sexual transmission may facilitate the spread of Zika even in areas where mosquitoes carrying the virus are not present. Officials also want to prepare for the possibility that clusters of local infection will continue to pop up in parts of the United States for years to come. (Saint Louis, 8/26)

The Washington Post: FDA Takes Radical Measure Of Recommending Zika Screening For Entire U.S. Blood Supply
Marks, director of the FDA’s Center for Biologics Evaluation and Research, said the advisory was put out because "there is still much uncertainty regarding the nature and extent of Zika virus transmission." In a media conference call, he noted the “rapid expansion” of the virus, which is actively spreading in more than 50 countries, mostly in the Americas and Caribbean. The United States has documented 8,000 cases of Americans who acquired the virus abroad and 2,000 infected through local transmission. Nearly all of those in the latter group are in Puerto Rico. (Cha, 8/26)

The Wall Street Journal: FDA Calls For Zika Testing Of All Blood Donations
Dr. Marks said testing of blood donations already is under way in Puerto Rico and Florida, where most of the U.S. Zika cases have occurred. The plan, he said, is to expand that testing in 11 more states over the next four weeks. They are Alabama, Arizona, California, Georgia, Hawaii, Louisiana, Mississippi, New Mexico, New York, South Carolina and Texas. Testing should begin in all states within 12 weeks, Dr. Marks said. “Given the very serious outcome of small-headed babies,” said Dr. Marks, “in order to prevent that from happening, we feel this step makes sense.” (Burton, 8/26)

NPR: FDA Says All Blood Donations Should Be Tested For Zika
Currently, Zika is being spread by mosquitoes in South Florida, Puerto Rico and the U.S. Virgin Islands, as well as most countries in the Caribbean and Central and South America. There are a total of 2,517 cases of Zika in the U.S. states and D.C., according to the Centers for Disease Control and Prevention, with 9,011 more in U.S. territories. (Neel, 8/26)

The Hill: FDA: All Blood Donations Should Be Tested For Zika 
Several members of Congress, led by Rep. Lloyd Doggett (D-Texas), first urged the FDA on July 20 — before the Zika was spreading locally in Florida — to implement mandatory screening for all blood donations. “If we wait for the first confirmed locally transmitted Zika case to begin testing, we risk serious harm to the stability of our blood supply,” Doggett wrote to FDA Commissioner Dr. Robert Califf. Implementing the additional screening will be costly, Marks acknowledged, though he declined to say how much the FDA will need to spend. (Ferris, 8/26)

Politico Pro: 'Virtually All' Zika Funding Will Run Out Next Month, HHS Warns 
The Obama administration has spent nearly all of the funding it had reallocated from Ebola to fight the Zika virus, HHS Secretary Sylvia Mathews Burwell told lawmakers in a letter obtained by POLITICO. "Our nation's ability to mount the type of Zika response that the American people deserve sits squarely with Congress," Burwell wrote. The $374 million the administration took from efforts to fight Ebola “will be virtually exhausted by the end of the fiscal year” on Sept. 30, she said. The dire warning comes a week before lawmakers are due to return to Congress following a seven-week break. (Haberkorn, 8/27)

The Hill: Obama Calls For Quick Zika Action From Congress After Recess 
President Obama is urging Republicans to make funding for fighting the Zika virus their top priority once Congress comes back into session. “Every day that Republican leaders in Congress wait to do their job, every day our experts have to wait to get the resources they need — that has real-life consequences,” Obama said. “Weaker mosquito-control efforts. Longer wait times to get accurate diagnostic results. Delayed vaccines. It puts more Americans at risk. (Hensch, 8/27)

And in other Zika news —