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KHN First Edition: July 6, 2015


First Edition

Monday, July 06, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: LA Police Unit Works To Get Treatment For Mentally Ill Instead Of Jail Time
Southern California Public Radio's Stephanie O'Neill, working in partnership with Kaiser Health News and NPR, reports: "The Los Angeles Police Department’s mental evaluation unit is the largest mental health policing program of its kind in the nation, with 61 sworn officers and 28 mental health workers from the county. The unit has become a vital resource for the 10,000-person police force in Los Angeles." (O'Neill, 7/6)

The New York Times: Health Insurance Companies Seek Big Rate Increases For 2016
Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back. Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives. (Pear, 7/3)

The Wall Street Journal: Oregon Backs Hefty Rise In Health-Insurance Premiums
Oregon’s insurance regulator has approved big premium increases sought by health plans for 2016 under the health law, and in some cases ordered higher raises than insurers requested, signaling that the cost of insurance for people who buy it on their own could jump after two years of relatively modest growth. Around the U.S., the biggest insurers have proposed hefty premium increases for the year ahead, based on what they say they now know about the costs of covering people newly enrolled under the Affordable Care Act. Supporters of the health law have been counting on state regulators to rein in hefty premium increases for the law’s third year in full effect. (Radnofsky, 7/3)

The Associated Press: Aetna To Buy Humana As Health Insurer Landscape Shifts
Aetna aims to spend about $35 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal health care overhaul. The proposed cash-and-stock deal, announced early Friday, would make Aetna a sizeable player in the rapidly growing Medicare Advantage business, which offers privately run versions of the federally funded health care program for the elderly and some people with disabilities. (Murphy, 7/3)

The New York Times: Aetna Agrees To Acquire Humana For $37 Billion In Cash And Stock
The deal would bring together two of the biggest health insurers in the United States. The combined company would have estimated operating revenue of $115 billion this year and serve more than 33 million people. The proposed merger occurs as the nation’s largest for-profit health insurers seek ways to reduce costs and capitalize on growing opportunities in the government and individual markets. The companies say they will be able to operate more efficiently and negotiate more effectively with large health systems, which have also been consolidating. (Bray and Abelson, 7/3)

The Wall Street Journal: Aetna-Humana Merger Marks Sway Of Health-Care Law
The two chief executives said Friday changes stemming from the Affordable Care Act, which has pushed the industry toward individual coverage and new ways of paying providers, helped set the stage for their deal. The health law was “an action-forcing event that has catalyzed a lot of very important discussions,” Aetna CEO Mark Bertolini said. Humana CEO Bruce Broussard flagged changes in the health-care system that are often tied to the law, including an increasing focus on selling to individuals rather than employers. (Wilde Mathews, Hoffman and Matioli, 7/3)

USA Today: Aetna Buys Humana For $37B Amid Record Number Of Health Care Deals
Health care-insurance firm Aetna announced a $37 billion agreement Friday to acquire smaller rival Humana in a deal that continues the rapid consolidation in the U.S. health care industry. In the first six months of the year, a record $296 billion in deals have been announced in the industry, according to Dealogic, a research firm that specializes in mergers and acquisitions. (Hjelmgaard and Riley, 7/3)

The New York Times: With Merging Of Insurers, Questions For Patients About Costs And Innovation
The nation’s five largest health insurance companies are circling one another like hungry lions closing in on prey. ... As insurers grow larger, will consumers benefit from the companies’ ability to bargain with hospitals and doctors for lower prices? Will diminishing competition translate to fewer choices of plans? And what effect will mergers have on innovation in health care? The answers depend largely on how successfully the other insurers, particularly those that were created or attracted by the Affordable Care Act, can compete with these much larger companies. (Abelson, 7/5)

Los Angeles Times: Obamacare Cash Fuels Healthcare Merger Mania
Riding high on Wall Street and flush with cash, big health insurers in particular have been on the prowl for deals. Atop the shopping list are companies that boost their government business. “The Affordable Care Act is really driving this merger mania,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “There are billions of dollars pouring into the system, and it's money to buy insurance.” President Obama's signature health law has unleashed the biggest expansion of insurance coverage in half a century, lifting stock prices and revenues across the healthcare industry. (Terhune, 7/2)

The Wall Street Journal: With Merger Deal, Aetna, Humana Get Ahead Of The Pack
In the game of merger musical chairs the five biggest health insurers have been playing lately, Aetna Inc. and Humana Inc. hustled to grab the first seats. The two insurers disclosed their $34.1 billion tie-up after 2 a.m. EDT Friday, as the holiday weekend was beginning and after reports that rivals Anthem Inc. and Cigna Corp. had rekindled talks. ... The frenzied talks, sparked earlier this year by an overture to Humana, reflect managed-care companies’ desire to diversify and cut costs in the wake of the federal Affordable Care Act and other changes in the health-care industry. (Wilde Mathews, Hoffman and Mattioli, 7/5)

The Associated Press: Insurer Merger Mania Paints Muddied Picture For Consumers
More than a third of the U.S. population has health coverage through an insurer that either wants to make a huge acquisition or is about to be swallowed up in one. Aetna laid out a plan on Friday to spend around $35 billion to buy the Medicare Advantage provider Humana Inc. That came a day after Centene Corp. and Health Net Inc. announced a smaller deal and a couple of weeks after Anthem Inc. went public with its offer of more than $47 billion for Cigna Corp. (Murphy, 7/3)

USA Today: Aetna, Humana CEOs Say Deal Bolsters Medicare, Medicaid Businesses
The CEOs of Aetna and Humana say the $37 billion merger they announced Friday will help consumers because of the two companies' complementary strengths in technology and relationships with health care providers. The combined company's government business — Medicare, Medicaid and Tricare — will be based in Louisville and will be the biggest part of the company, totaling about 56% of the combined companies' projected 2015 operating revenue of about $115 billion. (O'Donnell and Ungar, 7/3)

The Washington Post: Clinton Warns That A Republican President Would Repeal Obamacare
Hillary Rodham Clinton sharpened her partisan rhetoric to appeal to Democratic primary voters [in New Hampshire] Friday by issuing a dire warning: President Obama's health care law would disappear if a Republican wins the White House in 2016. ... "If the country elects a Republican president, they will repeal the Affordable Care Act. That is as certain as I can say it," she continued, noting the unlikelihood that Democrats take over the Senate and House next year. (Rucker, 7/3)

The New York Times: Hillary Clinton Warns That A Republican President Would Repeal The Health Law
Mrs. Clinton’s speech demonstrated the challenge she faces: She must keep a wary eye on Mr. Sanders without attacking him, but she must also seem engaged and rouse her supporters, so attacks on the Republican field on issues like the Affordable Care Act have been her approach. She kept to that script here on Friday, warning that a Republican president would repeal the health care law, and she denounced the administration of George W. Bush for “poor management” of the economy that led to the recession. (Haberman, 7/3)

Reuters: U.S. Republican Christie Criticizes High Court's Gay Marriage Ruling
U.S. Republican presidential candidate Chris Christie said on Sunday Supreme Court justices of his liking would not have legalized same-sex marriage and would have struck down a key provision of a national health care law. ... "If the Christie-type justices had been on that court in the majority, we would have won those cases in the Supreme Court rather than lost them," he told "Fox News Sunday" in an interview. (Lange, 7/5)

The Fiscal Times: Christie Doubles Down On Vow To Overhaul Medicare And Social Security
It t has never been a way to win friends and influence voters, but New Jersey Gov. Chris Christie isn’t shying away from reform of two “do-not-touch” entitlements—Medicare and Social Security. His goal is to cut the long-term debt since formally announcing his improbable campaign for the GOP presidential nomination last week. ... During an interview today on “Fox News Sunday,” Christie doubled-down on his pledge to pursue major entitlement reform if he somehow overcomes other huge political liabilities to win the primary and general elections next year. “I put that plan forward and I’m going to keep talking about it,” Christie said. They say don’t touch it. I’m going to hug it.” (Pianin, 7/5)

NPR: Liberal Minority Won Over Conservatives In Historic Supreme Court Term
The court's other major decision at the end of the term upheld nationwide subsidies in the Affordable Care Act. And as [Walter] Dellinger observes, Chief Justice John Roberts' opinion for a 6 to 3 majority was "surprisingly favorable" to the law. "The first five pages of the chief justice's opinion ... is the best articulation of the case for the Affordable Care Act anybody has written," Dellinger says. The decision did something else important. It sided with the liberal view that legislation should be interpreted in terms of its overall purpose and not by flyspecking a phrase here and there. (Totenberg, 7/6)

The Wall Street Journal: House GOP And White House Trade Shots Over Obamacare
The Supreme Court showdown over the Affordable Care Act may be over, but the legal offensive against the law isn’t. Lawyers representing the Republican-controlled House of Representatives and the Obama administration took their best shots at each other’s arguments this week in their battle over Obamacare. The case, filed in federal court in Washington, D.C. last year, is about whether the executive branch overstepped its bounds in how it’s paying for and enforcing parts of the health law. (Gershman, 7/2)

Los Angeles Times: Indiana's Medicaid Experiment Offers A Conservative Take On Health Reform
Indiana, which has a conservative Republican governor and Legislature, is pioneering an experiment that requires low-income patients to contribute monthly to a special health account. ... Charging poor people small premiums or fees for care — long favored by conservatives who contend that "skin in the game" engages patients in their health — has historically produced mixed results. But at a time when Obamacare remains deeply unpopular among Republicans, the idea is attracting new interest as GOP governors seek ways to put a conservative stamp on expanding coverage. Indiana's experiment may provide a glimpse at where the health law is headed in some parts of the country. (Levey, 7/4)

The New York Times: In Health Law, A Boon For Diet Clinics
Dr. Michael Kaplan looked across his desk at a woman who had sought out his Long Island Weight Loss Institute .... By the end of the 50-minute session, the woman had chosen Dr. Kaplan’s most expensive weight-loss plan: $1,199 for six weeks’ worth of meal-replacement products, counseling and vitamin supplements. ... Then he delivered some good news: Her insurance would probably reimburse her for at least a small portion of the bill, thanks to a provision in the federal health care law that requires insurers to pay for nutrition and obesity screening. The news was pleasing to the patient. But it has also created a financial opportunity for a corner of the diet industry that has often operated on the fringe of the medical establishment: for-profit diet clinics overseen by doctors. (Abrams and Thomas, 7/4)

The New York Times: Effective Concussion Treatment Remains Frustratingly Elusive, Despite A Booming Industry
The search for ways to treat and prevent concussions has spawned screening tools, helmet sensors, electronic mouthpieces, diagnostic blood tests and brain imaging devices. ... But as the industry booms, medical experts are raising concerns that it is a business where much of the science is sketchy, belief frequently outruns fact, and claims of technological breakthroughs evaporate soon after they are made. (Meier and Ivory, 7/3)

The Washington Post: ‘Navigators’ For Cancer Patients: A Nice Perk Or Something More?
In the 71 days since she first saw her doctor about a suspicious lump in her right breast, Ricki Harvey has had 40 appointments about her medical care. ... At Harvey’s side every step of the way were “patient navigators,” in her case nurses, whose job is to help guide cancer patients through a system that has become so complex and fragmented that it is beyond the ken of many people, especially at such a vulnerable time. (Bernstein, 7/3)

The Washington Post: Alzheimer’s Spurs The Fearful To Change Their Lives To Delay It
When Jamie Tyrone found out that she carries a gene that gives her a 91 percent chance of developing Alzheimer’s disease beginning around age 65, she sank into a depression so deep that at times she wanted to end her life. Then she decided to fight back. She exercised. She changed her diet. She began taking nutritional supplements .... Perhaps the only thing as bad as Alzheimer’s disease is the fear among a growing number of older Americans that they may be at risk of the neurodegenerative disorder, which robs memory and cognitive ability and is the leading cause of dementia. (Kunkle, 7/4)

Los Angeles Times: California Tax Officials Blast Blue Shield In Audit
In a scathing audit, state tax officials slammed nonprofit health insurer Blue Shield of California for stockpiling "extraordinarily high surpluses" — more than $4 billion — and for failing to offer more affordable coverage or other public benefits. The California Franchise Tax Board cited those reasons, among others, for revoking Blue Shield's state tax exemption last year, according to documents related to the audit that were reviewed by The Times. These details have remained secret until now because the insurer and tax board have refused to make public the audit and related records. (Terhune, 7/5)

The Wall Street Journal: Vertex’s $259,000 Cystic Fibrosis Drug Gets FDA Approval
The U.S. Food and Drug Administration approved Vertex Pharmaceuticals Inc.’s cystic-fibrosis drug Orkambi, which could treat as many as 8,500 patients in the U. S.—but at a whopping annual wholesale cost of $259,000 per patient. ... The drug is the latest to carry a potentially budget-busting price tag. Others are for cancer and hepatitis C. (Armental and Burton, 7/2)

The Washington Post: Are Risks Worth The Rewards When Nonprofits Act Like Venture Capitalists?
But frustrated that no game-changing treatments were in sight, the [Cystic Fibrosis Foundation's] leaders in 1999 placed what many considered a risky bet, deciding to invest millions of dollars in a small California biotech firm. ... That initial bet, which over time grew into a $150 million investment, has paid off in a big way. It led to the approval in 2012 of a breakthrough drug — the first that treats the underlying cause of cystic fibrosis rather than the symptoms, in a small subset of patients. On Thursday came another big win: The Food and Drug Administration approved a second drug for the group also helped fund development; that drug eventually could aid roughly half of the 30,000 cystic fibrosis patients in the United States. (Dennis, 7/2)

Minneapolis Star Tribune: Mayo Makes Case For Medicare Reimbursement For Telemedicine
Nurses Jennifer Meindel and Chad Ditlevson stand in front of monitors in a small room at the Mayo Clinic reading vital signs and occasionally calling up video images of patients lying in beds. All of the 40-some patients cycling across the screens are in intensive care in the Mayo Clinic Health System. But none of them are actually at Mayo. ... But even as they deliver intensive care in hospitals that could not otherwise provide it, government and private health insurance companies are not reimbursing them. “Medicare pays me if I’m at the bedside,” Brown explained. “They will not pay for telemedicine.” So Mayo absorbs the cost of providing the service to seven hospitals that are part of the Mayo Clinic Health System. Mayo’s Medicare reimbursement issue is representative of a national dilemma. Health care payment policies often lag cost-saving advances in technology by many years. (Spencer, 7/4)

Los Angeles Times: Patients Swamped With Medical Bills Find A Solution In Crowd-Funding
When a young couple from Florida couldn't get their insurance company to pay for in-vitro fertilization, they turned to the Internet for help. Using a crowd-funding website called Indiegogo, they set up a campaign to raise $5,000. Online contributions of more than $8,000 ultimately rolled in from friends, family and strangers. And now they have a baby. That's the power of a crowd, says Slava Rubin, CEO of Indiegogo, based in San Francisco. Crowd-funding has grown along with the Internet as people increasingly band together to support charities, raise money for movies and other projects — and now seek money to pay medical bills. (Zamosky, 7/3)

The New York Times: Colorado’s Effort Against Teenage Pregnancies Is A Startling Success
Over the past six years, Colorado has conducted one of the largest ever real-life experiments with long-acting birth control. If teenagers and poor women were offered free intrauterine devices and implants that prevent pregnancy for years, state officials asked, would those women choose them? They did in a big way, and the results were startling. The birthrate for teenagers across the state plunged by 40 percent from 2009 to 2013, while their rate of abortions fell by 42 percent, according to the Colorado Department of Public Health and Environment. There was a similar decline in births for another group particularly vulnerable to unplanned pregnancies: unmarried women under 25 who have not finished high school. (Tavernise, 7/5)

The Associated Press: Washington Woman's Measles Death Is First In US Since 2003
Measles killed a Washington woman in the spring — the first such death in the U.S. in 12 years and the first in the state in 25, health officials said Thursday. The case wasn't related to a recent measles outbreak that started at Disneyland and triggered a national debate about vaccinations, according to the Washington State Department of Health. Officials said it was a different strain. The Washington woman lacked some of the measles' common symptoms, such as a rash, so the infection wasn't discovered until an autopsy, department spokesman Donn Moyer said. (Bellisle, 7/3)

USA Today: Measles Kills First Patient In 12 Years
The woman was probably exposed to measles at a medical facility during a measles outbreak this spring, according to the health department. She was at the hospital at the same time as a patient who later developed a rash and was diagnosed with measles. Patients with measles can spread the virus even before showing symptoms. The woman, who died of pneumonia, had other health conditions and was taking medications that suppressed her immune system, the health department said. (Szabo, 7/3)

Arizona Republic/USA Today: Private Care For Vets Plagued By Delays, Say VA Inspectors
Inspectors for the Department of Veterans Affairs say a community-referral program designed to make private medical treatment available for veterans is plagued by delays in care, improper patient scheduling practices, cost overruns and other problems. The findings make it clear that former military personnel who have suffered stress and medical complications because of delayed treatment in VA medical centers are now encountering the same problems when they get referred by the VA for private care. (Wagner, 7/3)

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