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KHN First Edition: October 20, 2016


First Edition

Thursday, October 20, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Burwell Says Upcoming Enrollment Efforts Are Pivotal For Health Law
Mary Agnes Carey reports: "Rate hikes are likely on the way for plans offered on the health law’s online exchanges, or marketplaces. Consumers’ out-of-pocket costs are expected to climb, and some major insurers are pulling out. Department of Health and Human Services Secretary Sylvia Burwell Wednesday acknowledged that the Affordable Care Act’s fourth enrollment season, scheduled to begin Nov. 1 and run until Jan. 31, is a pivotal time for President Barack Obama’s signature domestic policy achievement. (Carey, 10/19)

Kaiser Health News: An Idea Borrowed From South Africa: Ordinary Citizens Fill Gaps In Health Care
Sarah Varney reports: "Destini Belton isn’t a doctor or a nurse. She’s a trained health coach, and as a trusted neighbor in Harlem, she goes where clinics and hospitals can’t — into patients’ homes to understand the mundane but vital details of their lives. She visits people like Jessica Gonzalez who went blind at the age of 22 because of uncontrolled Type 1 diabetes. Now 33, Gonzalez has high blood pressure, high cholesterol and renal disease. Belton worries that Gonzalez isn’t taking the right medication at the right time because she can’t see the bottles." (Varney, 10/20)

Kaiser Health News: Emergency Room Use Stayed High In Oregon Medicaid Study
Oregon Public Broadcasting's Kristian Foden-Vencil reports: "Will Medicaid expansion save the country money as people stop using expensive emergency rooms for primary care?Not in the first years, said a study published Wednesday online in the New England Journal of Medicine. The study found ER use among Medicaid patients in Oregon stayed high even two years after people gained coverage, and even as more patients visited doctors’ offices, too." (Foden-Vencil, 10/19)

California Healthline: California’s RN Wages Now Highest In The Nation, Federal Data Show
Ana B. Ibarra reports: "Deborah Burger, co-president of the California Nurses Association, says that when she started her career as an intensive care unit nurse in the 1970s, a grocery clerk made more money than she did. Things have changed quite a bit since then, especially in California. Registered nurses in the Golden State earn $100,000 a year on average, more than their counterparts anywhere else in the country, according to recently-released data from the Bureau of Labor Statistics. The average hourly wage for registered nurses in California is $48.68 an hour, the 2015 data shows." (Ibarra, 10/20)

Kaiser Health News: West Virginia Grapples With High Drug Costs
West Virginia Public Broadcasting's Kara Lofton reports: "Skyrocketing prices for essential medicines, like the EpiPen, are generating public outcry, congressional hearings and political promises for policy fixes. In the meantime, the increases continue to hit pocketbooks — even of people who don’t rely on these expensive drugs. In a state like West Virginia, where dire budget shortfalls have been common over the past few years, the problem is especially pronounced. Kimberly Earl, of Charleston, W.Va., is feeling the pinch. She has four children, all of whom need medication." (Lofton, 10/20)

The New York Times: Donald Trump Won’t Say If He’ll Accept Result Of Election
The two candidates tangled over abortion rights. After initially declining to flatly say whether he would support overturning Roe v. Wade, the 1973 Supreme Court decision that legalized abortion, Mr. Trump conceded that the justices he would appoint to the court would do just that. “If we put another two or perhaps three justices on, that’s really what will happen,” he said. “That’ll happen automatically in my opinion.” (Healy and Martin, 10/19)

The Wall Street Journal: Final Debate: Donald Trump Declines To Commit To Respecting Results If He Loses
Mr. Trump promised he would appoint justices who would overturn the Roe v. Wade abortion decision and protect gun rights. “They will have a conservative bent,” he said. “I will be appointing pro-life judges.” Mrs. Clinton said she would choose justices who would protect abortion rights, same-sex marriage and overturn Citizens United, which removed limits on corporate and union spending in elections. “The Supreme Court needs to stand on the side of the American people, not on the side of the powerful corporations and the wealthy,” she said. (Meckler, Bender and Nicholas, 10/20)

The Washington Post: At Third Debate, Trump Won’t Commit To Accepting Election Results If He Loses
Trump went on to describe late-term abortion procedures in graphic language, suggesting that many women end their pregnancies in the final one to four days. “You can take the baby and rip the baby out of the womb,” he said. Clinton used the moment to make a gender-based argument, telling Trump: “You should meet with some of the women I’ve met with, women I’ve known over the course of my life. This is one of the worst possible choices that any woman and her family could possibly make. . . . The government has no business in the decisions that women make with their families.” (Tumulty and Rucker, 10/19)

The Washington Post: Trump, Clinton Answers On Social Security Were Victories For The Left
Chris Wallace’s questions did assume that entitlements needed to be cut. He asked Trump if he would “make a deal to save Medicare and Social Security that included both tax increases and benefit cuts, in effect, a grand bargain on entitlements,” and asked Clinton if she would back “a deal that includes both tax increases and benefit cuts.” But neither candidate accepted the premise. Trump insisted, tautologically, that his tax cuts would spur the economy “to grow at a record rate of growth,” solving any problem with entitlement spending. Clinton said she would raise taxes on the rich to expand benefits; “that will come from either raising the cap and/or finding other ways to get more money into it,” she said. “I will not cut benefits. I want to enhance benefits for low-income workers and for women who have been disadvantaged by the current Social Security system.” (Weigel, 10/20)

The Associated Press Fact Check: Trump, Clinton And Their Debate Claims
Clinton is basically on target, but Medicare's funding problems are more complicated than she implies. The 2010 health care law was partly financed with cuts in future payments to hospitals, insurers and other Medicare service providers. According to projections at the time, that extended the solvency of the Medicare trust fund to 2029. (Otherwise Medicare would have been unable to fully pay its bills in 2017.) Republican budgets since then have kept Obama's Medicare cuts. But the health care law did not solve Medicare's financial problems. (10/20)

The Associated Press Fact Check: Health Insurance Costs Up, But Not Doubling
Premiums are going up, and by double digits in many states, but to say it's over 100 percent is pure hyperbole. The full impact of next year's premium increases is going to take time to sort out and vary across the country. Full information will be available Nov. 1 when the market goes live. (10/20)

The Associated Press: Modest Gain Seen For Obama's Last Health Care Sign-Up Season
Some 13.8 million people are expected to sign up for 2017 coverage, Health and Human Services Secretary Sylvia Burwell said. That would be an increase of a bit less than 9 percent from the 12.7 million who picked plans during open enrollment for this year. This year is shaping up to be the most difficult sign-up season since launched in 2013 and the computer system froze up. But technology isn't the issue this time. Premiums are going up by double digits in many communities, and some major insurers have left the program, leaving consumers with fewer choices next year. (10/19)

The Wall Street Journal: Obama Administration Expects Robust Open Enrollment Under ACA
The administration is under pressure to bolster enrollment to help stanch insurers’ financial losses, which have led some major carriers to pull out or scale back from the exchanges. To boost enrollment, the government will use television ads, direct mail and other targeted outreach efforts to potential enrollees, particularly young people. But the enrollment period, which starts Nov. 1 and runs through Jan. 31, 2017, also coincides with political turbulence brought about by the campaigns, the election and the transition to a new president and Congress in January. (Armour, 10/19)

The Washington Post: ACA Enrollment To Rise By 1 Million Next Year, Obama Administration Projects
Burwell used the annual enrollment prediction as a kind of paean to what she heralded as “the biggest step forward in a generation” — the administration’s work to usher in insurance that is better, more affordable and more broadly available. She acknowledged that future ACA proponents will need Congress as a partner to accomplish any “substantial changes” in the law, including a public insurance option to foster more market competition in places with few insurers. The secretary contended that the law’s marketplace “is sustainable in terms of its size.” In remarks at HHS headquarters, she said that it is “strong — and will continue to be strong — because it is offering a product that people want and need.” (Goldstein, 10/19)

Los Angeles Times: Obamacare Enrollment Is Expected To Grow By Just 1 Million Next Year
“Building a new market is never easy,” Health and Human Services Secretary Sylvia M. Burwell said Wednesday in remarks at the agency. “And as I’ve said before, we expect this to be a transition period for the marketplace. Issuers are adjusting their prices, bringing them in line with actual data on their costs. And at HHS, we’re enhancing the stability of the marketplace, and making it stronger for the future.” But Burwell renewed calls on Congress to help make adjustments to the law to make the marketplaces more sustainable. (Levey, 10/19)

Reuters: Obama To Give His Diagnosis For What Ails Obamacare
President Barack Obama on Thursday will head to the election battleground state Florida to give his prescription for fixing the Affordable Care Act, his signature healthcare law, but any remedies will be left up to his successor and the next Congress. (Humer, 10/20)

The Associated Press: Obama To Urge Young Adults To Sign Up For Health Care
President Barack Obama wants to encourage people to sign up for health care coverage under the Affordable Care Act during an upcoming enrollment period. It's the final sign-up season for Obama's prized health care overhaul and he wants it to be a success. But his signature domestic achievement is being buffeted by double-digit premium increases and fewer insurers offering coverage. (10/20)

NPR: Inflectra To Cost Only 15 Percent Less Than Remicade
Generic drugs generally cost 80 percent less than brand-name drugs, so hopes were high when a law enacted in 2010 paved the way for competition among the highest-priced drugs of all, known as biologics. But, as these competing drugs start to appear on the market, consumers aren't reaping a windfall. (Harris, 10/19)

USA Today: VA Shuffles Managers, Declares ‘New Leadership’
Although Veterans Affairs Secretary Bob McDonald has asserted that more than “90%” of the VA’s medical centers have “new leadership” or “leadership teams” since he took over the troubled agency in 2014, a USA TODAY investigation found the VA has hired just eight medical center directors from outside the agency during that time. (Slack, 10/18)

The Washington Post: Report: More Than Half Of Mentally Ill U.S. Adults Get No Treatment
Mental Health America just released its annual assessment of Americans with mental illness, the treatment they receive and the resources available to them — and the conclusions are sobering: Twenty percent of adults (43.7 million people) have a mental health condition, and more than half of them do not receive treatment. Among youth, the rates of depression are rising, but 80 percent of children and adolescents get either insufficient treatment or none at all. (Nutt, 10/19)

The New York Times: In Quick Response, De Blasio Calls Fatal Shooting Of Mentally Ill Woman ‘Unacceptable’
Deborah Danner’s essay recounted her long, aching struggle with schizophrenia, a battle that had begun some 30 years earlier.Filed away last year by a lawyer who had been helping Ms. Danner, the neatly typed, six-page composition depicted a disturbing roll of memories, like the early morning spent roaming the streets of New York City with a knife, searching for a place to end her own life. (Rosenberg and Southall, 10/19)

The Associated Press: NY Tells Health Insurers To Cover Addiction Treatment Drugs
New York state is requiring more health insurers to cover the cost of medications used to help those struggling with opioid addiction.The steps announced Wednesday by the Department of Financial Services apply to those covered under large-group insurance policies. State officials say they "mirror" the rules already covering small-group and individual policies. (10/20)

The Washington Post: Delaware Attorney General Eyes Heroin, Opioid Abuse Efforts
Attorney General Matt Denn says more work is needed to tackle heroin addiction and prescription painkiller abuse in Delaware. Denn on Wednesday said the state’s prescription drug monitoring program needs to be tightened to help officials identify prescribing patterns that should be referred to police or medical licensing authorities. (Chase, 10/19)

The New York Times: Children 14 Or Under Need Fewer H.P.V. Vaccine Doses
Children 11 to 14 years old need only two doses of the H.P.V. vaccine, not the previously recommended three doses, to protect against cervical cancer and other cancers caused by the human papillomavirus, the Centers for Disease Control and Prevention said on Wednesday. But teenagers and young adults who start the vaccinations later, at ages 15 through 26, should stick with the three-dose regimen, the disease centers said. (Grady, 10/19)

The Washington Post: CDC Now Recommends Just Two HPV Vaccine Doses For Preteens
Children who start getting vaccinated against human papillomavirus before 15 need only two doses, the Centers for Disease Control and Prevention decided Wednesday. Its previous recommendation was for a three-shot regimen, but studies have shown that two doses work just as well. Experts predict that the simpler, more flexible timeline will result in higher rates of HPV vaccination, which has lagged among both girls and boys. (McGinley, 10/19)

The New York Times: Reported Cases Of Sexually Transmitted Diseases Are On Rise
There were more cases of sexually transmitted diseases reported in the United States last year than ever before, according to new federal data. Rates of chlamydia, gonorrhea and syphilis — three of the most common S.T.D.s — grew for the second consecutive year, with sharper increases in the West than other regions. And while all three diseases are treatable with antibiotics, most cases continue to go undiagnosed, potentially causing infertility and other problems. (Goodnough, 10/19)

The Associated Press: Agency Says It Erred In Requiring Husband's OK For Abortion
A South Carolina agency said Wednesday it erred in suggesting married women get their husband's permission to get an abortion. That is among proposed changes to abortion clinic regulations that the state's health agency put out last month for public comment, following a unanimous vote by the agency's board. Abortion rights advocates called them extreme and politically driven. (10/19)

The Washington Post: There’s A Breast Microbiome, And It’s Different In Women With Breast Cancer
Among the most popular topics in biology in recent years is the human microbiome, the trillions of bacteria and other tiny organisms inside and outside our bodies that outnumber our own cells by as much as 3 to 1. Much of the news on this topic has been about the colony of bacteria deep in your gut; scientists believe that the mix may contribute to all sorts of medical conditions including from Crohn’s disease, an inflammatory bowel disorder, and anxiety. Now it looks as though the microbiomes in other parts of our bodies may also play an important role in disease. (Blakemore, 10/19)

The Washington Post: Will Babies Be Better Off If We Know Their Genes?
Genome sequencing is supposed to be the future of medicine — a revolution that will bring about a new age of tailored treatments and unprecedented insight into people's individual biology. But perhaps nowhere are the “what if?” questions raised by genome sequencing more complex and ethically treacherous than at birth: Should we sequence the DNA of healthy newborn babies? (Johnson, 10/19)

The Washington Post: App Helps Save Seattle Cardiac Patient
If your heart is going to stop, right outside a hospital is not a bad place for it. And if 41 people within a 330-yard radius have a cellphone app alerting them to your distress, so much the better. That’s what happened in Seattle last week when Stephen DeMont collapsed at a bus stop in front of University of Washington Medical Center. (Johnson, 10/20)

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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