Kaiser Health News Original Stories

4. Political Cartoon: 'Ask No Questions, Hear No Lies?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Ask No Questions, Hear No Lies?'" by Dave Coverly, Speed Bump.

Here's today's health policy haiku:

HOW TIMES CHANGE

Medicare ignores
Old attacks on “death panels,”
And plans to fund talks.

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Medicare

5. Medicare Proposes Paying Doctors For End-Of-Life Discussions

Six years after a similar proposal nearly derailed passage of the Affordable Care Act, the Obama administration has revived a plan to reimburse physicians for talking with Medicare patients about how patients want to be cared for as they near death.

The New York Times: Medicare Plans To Pay Doctors For Counseling On End Of Life
Medicare, the federal program that insures 55 million older and disabled Americans, announced plans on Wednesday to reimburse doctors for conversations with patients about whether and how they would want to be kept alive if they became too sick to speak for themselves. The proposal would settle a debate that raged before the passage of the Affordable Care Act, when Sarah Palin labeled a similar plan as tantamount to setting up “death panels” that could cut off care for the sick. The new plan is expected to be approved and to take effect in January, although it will be open to public comment for 60 days. (Belluck, 7/8)

The Associated Press: Medicare's End-Of-Life Counseling Policy May Find Acceptance
Six years ago, a proposal for Medicare to cover end-of-life counseling touched off a political uproar that threatened to stall President Barack Obama's health care law in Congress. Wednesday, when Medicare finally announced it will make the change, reaction was muted. ... But for the Obama administration, end-of-life counseling remained politically radioactive, even as the idea found broader acceptance in society. Dr. Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine, called Medicare's move a "little miracle," given the "death panels" furor. He said he believes the controversy has passed. (Alonso-Zaldivar and Sedensky, 7/9)

The Wall Street Journal: End-Of-Life Talk Proposed As New Medicare Benefit
The federal government is proposing to pay health-care providers for talking to Medicare beneficiaries about end-of-life care after mounting calls for a better approach to conversations about dying that can both save costs and improve patient care. The rule proposed Wednesday would reimburse doctors, nurse practitioners and some others in the health industry for discussions about end-of-life care, which was championed last year in a report by the Institute of Medicine, an independent advisory body. (Armour and Radnofsky, 7/8)

Los Angeles Times: Obama Administration Revives Plan Once Criticized As 'Death Panels'
The new proposal from the Department of Health and Human Services would not require Medicare patients to sign any order or even to talk with their physicians about end-of-life care. Rather, the proposed regulation would allow medical providers to bill Medicare for "advance-care planning" should a patient want to have the discussion. Such a session could include “the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed) by the physician or other qualified health professional,” according to the proposed rule. (Levey, 7/8)

Huffington Post: Medicare Outlines End-Of-Life Planning Proposal That Will Make Sarah Palin's Head Explode
Medical societies and seniors' groups like the AARP have long supported so-called advance care planning as a way for patients to consider whether they want intensive medical care in the event of a life-threatening illness near the close of their lives, and to make their preferences known to their loved ones in writing. But Medicare has never had a mechanism with which to pay doctors for this counseling, except during a physical exam when beneficiaries first enroll in the program. (Young, 7/8)

Meanwhile, a look back at the origins of the palliative care movement -

The Kansas Health Institute News Service: Death And Dying: Expanding Palliative Care
A milestone multi-year study published in 1995 startled the medical world when it revealed that about half the hospital doctors treating terminally ill people were unaware when their patients had not wanted aggressive, life-extending treatments and that about half those who died in their care had pain that might have been abated. Equally shocking, the report found that follow-up efforts to improve the results at the teaching hospitals involved in the study had failed. (Shields, 7/8)

Health Law Issues And Implementation

6. GOP's Plan To Halt Health Law With Rare Budget Tool Has Stalled

Senate Republicans are downplaying any plans to use the tool, called reconciliation, to repeal large portions of the law with a simple majority vote.

Politico: Senate Downplays Obamacare Repeal
July was supposed to be the big month for Obamacare repeal in Congress. But Senate Republicans are downplaying expectations that they’ll use a powerful budget tool called reconciliation to undo Obamacare through a simple majority vote this summer — and conservatives are none too pleased. Republicans pledged earlier this year that they would use the budget reconciliation tool to knock out parts of Obamacare. That was to start this month, to get rid of some unpopular Obamacare taxes or mandates even if they can’t scrap the whole law. But persistent divisions among Republicans, along with the reelection concerns of some GOP senators in liberal or swing states, are again slowing things down. (Haberkorn and Bade, 7/9)

Meanwhile, some Indian companies see a growing outsourcing market coming from the health law.

Reuters: India IT Outsourcing Firms Seek Booster Shot From Obamacare
India's IT outsourcing firms are betting on U.S. President Barack Obama's healthcare reform to rev up revenue growth, which is slowing as the $146 billion industry's key financial and manufacturing clients spend less on software services. The United States is the biggest market for the outsourcing industry, and accounts for 90 percent of all healthcare-related contracts, which researchers Everest Group expect to more than double to about $68 billion in 2020 from nearly $31 billion two years ago, largely due to "Obamacare." (Bhattacharjee, 78)

7. Drumbeat Grows For Medicaid Expansion After High Court Upholds Health Law Again

Health industry and consumer groups continue to push for Medicaid expansion in the 21 states that opted not to expand eligibility under the health law, reports Stateline. Meanwhile, Montana faces tough negotiation with federal officials over its expansion plan, and a small Ohio program might serve as a model for Georgia.

Stateline: On Medicaid Expansion, A Question Of Math And Politics
With its ruling in King v. Burwell last month, the U.S. Supreme Court likely settled the question of whether President Barack Obama’s signature Affordable Care Act will survive. Whether and when the health law will be fully implemented in all 50 states is a different question. ... But in the mostly Southern and Midwestern states that have rejected expansion, opposition shows little sign of abating. (Vestal, 7/8)

Georgia Health News: A Good Omen For Georgia Medicaid Plan?
An Ohio program that gave insurance to thousands of low-income patients helped them improve on health measures and also produced unexpectedly low costs, according to a study published Tuesday. Those findings may have a significant impact in Georgia. State officials are considering a proposal from Grady Health System in Atlanta to extend coverage to uninsured Georgians through a special Medicaid “waiver.’’ Grady officials say the waiver program would be modeled after the Cleveland MetroHealth Care Plus program. (Miller, 7/8)

Texas News Service: Next: Expanding Health Coverage
The latest U.S. Supreme Court ruling upholding the Patient Protection and Affordable Care Act has created a new wave of activism. Texas health advocates are working to close the health care coverage gap for the state's 1.5 million uninsured adults. Anne Dunkelberg, associate director of Center for Public Policy Priorities, says working families are paying the price for the state's decision not to expand Medicaid coverage. She says a family of four earning $25,000 a year, considered above the poverty line, can pay as little as $45 a month for coverage with federal subsidies. (Galatas, 7/8)

Meanwhile, Arkansas moves forward with plans to create a state exchange -

The Arkansas Democrat-Gazette: For Health Exchange, Tech Code To Be Copy
In establishing its health insurance exchange for individual consumers, an Arkansas board will seek to copy computer code from another state's enrollment system rather than building its own code from scratch, the board decided Wednesday. At a meeting in Little Rock, the Arkansas Health Insurance Marketplace board also unanimously approved a name -- My Arkansas Insurance -- and a logo for the exchanges it is creating for individuals and small businesses. The logo features a pinwheel pattern, representing a colorful umbrella, inside an outline of the state's borders. (Davis, 7/9)