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KHN First Edition: Jan. 3, 2017


First Edition

Tuesday, January 03, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: For Some Patients In Marketplace Plans, Access To Cancer Centers Is Elusive
Kaiser Health News' consumer columnist Michelle Andrews reports: "Getting cancer is scary. Discovering that your marketplace plan doesn’t give you access to leading cancer centers may make the diagnosis even more daunting. As insurers’ shrink their provider networks and slash the number of plans that offer out-of-network coverage, some consumers are learning that their treatment options can be limited." (Andrews, 1/3)

Kaiser Health News: A Dying Man’s Wish To Save Others Hits Hospital Ethics Hurdle
Side Effects Public Media's Karen Shakerdge reports: "At 44 years old, Dave Adox was facing the end of his two year battle with ALS, also known as Lou Gehrig’s disease. He needed a ventilator to breathe and couldn’t move any part of his body, except his eyes. Once he started to struggle with his eyes — his only way to communicate — Adox decided it was time to die. He wanted to donate his organs, to give other people a chance for a longer life. To do this, he’d need to be in a hospital when he went off the ventilator. ... Adox was asking to be admitted to the hospital specifically to end his life. And despite the planning, his request made some people uncomfortable." (Shakerdge, 1/3)

Kaiser Health News: Offering Syringes Along With Prayers, Churches Help IV Drug Users
Taylor Sisk reports: "When Gov. Pat McCrory signed legislation in July legalizing syringe exchange programs in North Carolina, James Sizemore rejoiced. The pastor of a small church, Sizemore had — with the tacit approval of some, but not all, local law enforcement — been offering clean syringes to drug users to help them avoid contracting HIV and hepatitis C. Now he could do so without fear of arrest." (Sisk, 1/3)

The Associated Press: Congress Ushers In New Era Of All-Republican Rule
On Tuesday at noon, with plenty of pomp and pageantry, members of the 115th Congress will be sworn in, with an emboldened GOP intent on unraveling eight years of President Barack Obama's Democratic agenda and targeting massive legacy programs from Franklin D. Roosevelt and Lyndon B. Johnson such as Social Security and Medicare. ... First up for Republicans is repeal and delay of the health care law, expediting the process for scrapping Obama's major overhaul but holding off on some changes for up to four years. (Cassata, 1/2)

The New York Times: Job No. 1 For A New Congress? Undoing Obama’s Health Law
Congress often waits for a new president to take office before it gets down to business. This year, Republicans will drop that custom in their dash to scrap the Affordable Care Act. Within hours of the new Congress convening on Tuesday, the House plans to adopt a package of rules to clear the way for repealing the health care law and replacing it with as-yet-unspecified measures meant to help people obtain insurance coverage. (Pear, 12/31)

The Wall Street Journal: Republican Congress Promises To Move Quickly Toward Goals
One of the first goals for Republican leaders is to dismantle the Affordable Care Act. ... As with many of the Republican goals, the effort is creating a maze of challenges. The most pressing is how to develop a replacement for the 2010 health law without triggering the sort of disruptions that accompanied the law’s rollout, which in turn contributed to the Democrats’ loss of their Senate majority in 2014. (Hughes and son, 1/2)

Los Angeles Times: Congress Opens With An Ambitious Republican Agenda For The Trump Era
Republicans remain at odds on some high-profile issues — such as how aggressively to investigate Russian hacking in the 2016 election — and how to fulfill other big-ticket promises, such as replacing Obamacare. Despite firm Republican control of both the White House and Congress, the internal disputes have left them without a clear plan yet for Trump’s first 100 days, or an endgame for the two years of the 115th Congress. (Mascaro, 1/2)

The New York Times: With New Congress Poised To Convene, Obama’s Policies Are In Peril
The most powerful and ambitious Republican-led Congress in 20 years will convene Tuesday, with plans to leave its mark on virtually every facet of American life — refashioning the country’s social safety net, wiping out scores of labor and environmental regulations and unraveling some of the most significant policy prescriptions put forward by the Obama administration. (Steinhauer, 1/1)

The Associated Press: GOP Congress Feels It Has Mandate To Undo Obama's Agenda
Republicans' grip on all levers of power stands as a mandate to the GOP-led Congress, which will move swiftly to try to undo eight years of outgoing President Barack Obama's agenda. With Republican President-elect Donald Trump just weeks away from assuming office, GOP lawmakers plan to open the 115th Congress on Tuesday and immediately take steps to repeal Obama's health care law. ... House Minority Leader Nancy Pelosi says Democrats "stand ready to fight vigorously" to protect health care and other priorities. (Jalonick, 1/2)

The Washington Post: Claiming Mandate, GOP Congress Lays Plans To Propel Sweeping Conservative Agenda
Few presidential candidates have dominated the coverage of an election like Trump did in 2016. In the campaign’s final stretch, Republican candidates often got less attention for their records in Congress than for their positions on Trump’s controversial statements. The irony, as Democrats realized after the election, was that congressional Republicans were poised to have more influence over the national agenda in 2017 than congressional Democrats did after the 2008 election that put Obama in the White House with his party in control on Capitol Hill. (Weigel, 1/2)

Politico: Dems, GOP Get Ready For Showdown On Obamacare
The long-standing fight over Obamacare's repeal is about to become a battle over messaging. Instead of doing a victory lap after they start dismantling the law in January, Republicans will not only have to rewrite a massive law, they'll have to quickly sell the public on the idea that their plan is cheaper and won't leave millions of Americans uninsured. An early look at the GOP's plans shows that they will be pushing the idea that "universal access" to health insurance is better than mandatory "universal coverage," which has been the foundation of Obamacare. (Haberkorn and Pradhan, 1/3)

NPR: Obamacare Is First Item On Congress' Chopping Block
That new health care plan hasn't been fleshed out yet by Trump or his allies in Congress. So they say they'll vote to get rid of Obamacare, but delay its demise until they come up with a replacement that will cover the millions of people who have insurance thanks to the law. But insurance companies and health care analysts are worried. (Kodjak, 1/2)

The Washington Post: Why Obamacare Is Unlikely To Die A Swift Death
Congressional Republicans have long boasted that once they claim the reins of power, they will act quickly and decisively to roll back what they view as the most onerous piece of President Obama’s domestic agenda: the Affordable Care Act. But their actions starting Tuesday to end Obamacare will be far less sweeping, at least initially, than a full-blown repeal of the law. Democratic opposition and complex Senate rules mean that core pieces of the 2010 health-care overhaul are likely to remain, including the legal framework for the individual mandate and pieces of the state exchanges the law created. (Snell and DeBonis, 1/2)

Politico: Pence To Huddle With House Republicans Wednesday
Vice President-elect Mike Pence will rally House Republicans Wednesday morning on a plan to repeal Obamacare, POLITICO has learned — a counter-punch to President Barack Obama’s visit to the Hill the same day. Pence will meet with the full House Republican Conference to talk about the party’s plan to dismantle Obama’s signature health care law, according to a House Republican leadership aide. (Bade, 1/2)

The Associated Press: Obama’s Last Month: ‘Obamacare’ Defense, Chicago Speech
Obama also planned to answer questions about the future of the health care law next Friday during a livestreamed event at Blair House, just across Pennsylvania Avenue from the White House. Initially stunned by the defeat of Hillary Clinton, Democrats are now trying to organize a counter-attack to preserve the ACA, among the most significant expansions of the social safety net since Medicare and Medicaid were created 50 years ago. House Democratic leader Nancy Pelosi has urged her lawmakers to make health care their focus at the start of the year. (Lederman, 12/30)

Politico: Obama To Huddle With Hill Democrats On Saving Obamacare
Incoming Senate Minority Leader Chuck Schumer (D-N.Y.) has promised to stand firm against repeal efforts and subsequently, Republican efforts to replace the Affordable Care Act with a more conservative framework. And a conference call convened by House Democrats earlier this week focused largely on emphasizing the benefits of Obamacare, with House Minority Leader Nancy Pelosi (D-Calif.) noting that she sees parallels between the current situation and the 2005 effort by then-President George W. Bush to privatize Social Security, according to an aide on the call. (Kim, 12/30)

The Associated Press: Democrats Extol Health Care Law In Bid To Derail GOP Repeal
Senior House Democrats on Monday extolled the benefits of President Barack Obama's health care law in hopes of derailing Republican plans to gut the statute and over time replace it. In a conference call with reporters, House Minority Leader Nancy Pelosi said the GOP will begin its "assault" on the health care law when the 115th Congress convenes Tuesday. She said abolishing the law, known as the Affordable Care Act, as Republicans have promised will mean that people will pay more for their health insurance while getting much less than they do now. Undoing the law also will undermine Medicaid and Medicare, she said. (Lardner, 1/2)

The Wall Street Journal: Health-Law Backers Target Key Republican Lawmakers
Groups opposing GOP efforts to repeal the Affordable Care Act are zeroing in on a handful of senators who may be wary of killing the health law without a replacement in hand. Sens. Lamar Alexander and Bob Corker of Tennessee have already raised concerns about the strategy of “repeal then replace.” Tennessee’s insurance market is deeply troubled, and prolonged uncertainty could force the last remaining health plan to stop offering coverage. Sen. Susan Collins of Maine, a centrist Republican, has also voiced worries about an emerging GOP plan to repeal the law with an effective date likely two or three years later, then using that time to craft a replacement. (Radnofsky and son, 12/23)

The New York Times: After Obama, Some Health Reforms May Prove Lasting
The Affordable Care Act is in extreme peril .... But the transformation of American health care that has occurred over the last eight years — touching every aspect of the system, down to a knee replacement in the nation’s heartland — has a momentum that could prove impossible to stop. Expanding insurance coverage to more than 20 million Americans is among Mr. Obama’s proudest accomplishments, but the changes he has pushed go deeper. They have had an impact on every level of care. (Goodnough and Pear, 1/3)

The New York Times: Cornerstone: The Rise And Fall Of A Health Care Experiment
Cornerstone Health Care, a large physician group [in High Point, N.C.], made a big bet a few years back: It would get paid based not on how many procedures its doctors performed, but on how effectively they treated their patients. There’s a term for this: an accountable care organization. ... And by early 2015, Cornerstone’s bet looked like a winner. ... But the confirmation proved premature. ... an exodus of doctors had begun at Cornerstone. In the months that followed, nearly 70 of its 228 doctors left, many attracted by the chance to make more money at area hospitals. (Abelson, 12/23)

The New York Times: Hospitals In Safety Net Brace For Health Care Law’s Repeal
Before the health law, the hospital had to absorb the cost of caring for many uninsured patients like Mr. Colston. Now, with President-elect Donald J. Trump and the Republican-controlled Congress vowing to dismantle the law, Temple and other hospitals serving the poor are bracing for harsh financial consequences that could have a serious effect on the care they provide. ... In a letter to Mr. Trump and congressional leaders this month, the two biggest hospital trade groups warned of “an unprecedented public health crisis” and said hospitals stood to lose $165 billion through 2026 if more than 20 million people lose the insurance they gained under the law. They predicted widespread layoffs, cuts in outpatient care and services for the mentally ill, and even hospital closings. (Goodnough, 12/27)

The Associated Press: With Trump's Victory, GOP Hopes To Overhaul Medicaid
Trump initially said during the presidential campaign that he would not cut Medicaid, but later expressed support for an idea pushed for years by Republicans in Congress — sending a fixed amount of money each year to the states in the form of block grants. Backers say such a change in the Medicaid formula is one of the best ways to rein in spending, but critics say big cuts would follow. ... Republicans have argued that states have little incentive to keep expenses under control, because no state pays more than half the total cost. (Cassidy, 12/29)

NPR: The Future Of Medicaid May Be Found In Indiana, Where The Poor Pay
To get a glimpse of where Medicaid may be headed after Donald Trump moves into the White House, it may be wise to look to Indiana. That's where Seema Verma, Trump's pick to run the Centers for Medicare and Medicaid Services, comes from. And that's where she put her stamp on the state's health care program for the poor. (Kodjak, 12/27)

The Associated Press: Texas Judge Halts Federal Transgender Health Protections
The latest injunction signed by U.S. District Judge Reed O'Connor comes four months after he blocked a higher-profile new set of transgender protections — a federal directive that required public schools to let transgender students use bathrooms consistent with their gender identity. Several of the Republican-controlled states that brought that lawsuit, including Texas, also sued over the health regulations that were finalized in May. Civil rights groups had hailed the new health rules as groundbreaking anti-discrimination protections. (Weber, 12/31)

Reuters: U.S. Judge Blocks Transgender, Abortion-Related Obamacare Protections
A federal judge in Texas on Saturday issued a court order barring enforcement of an Obama administration policy seeking to extend anti-discrimination protections under the Affordable Care Act to transgender health and abortion-related services. The decision sides with Texas, seven other states and three Christian-affiliated healthcare groups challenging a rule that, according to the judge, defines sex bias to include "discrimination on the basis of gender identity and termination of pregnancy." (Gorman, 12/31)

The Washington Post: Catholic Groups Sue Over Obama Administration Transgender Requirement
An organization of Catholic businesses is suing the Obama administration over a federal rule they say will force Catholic hospitals and doctors to perform gender reassignment services against their faith. The Catholic Benefits Association filed the lawsuit Wednesday in North Dakota District Court along with the Catholic Diocese of Fargo. In a statement, the groups called the rule part of a “multi-agency effort to redefine the term ‘sex’ in federal anti-discrimination laws.” (Somashekhar, 12/29)

USA Today: Soaring Insulin Prices Prompt Insurance Shift
Many parents of diabetic children and adults suffering with type 1 or type 2 diabetes are bracing for changes in insurance coverage of their insulin next year, as prices of the vital medication continue to soar. Higher insurance deductibles and changes in the prescription brands covered by some insurers are raising concerns among some people with diabetes. (O'Donnell, 1/2)

Bloomberg: Trump Said To Discuss Veterans’ Care Overhaul With Hospital CEOs
President-elect Donald Trump met at his Florida resort on Wednesday with leaders of top U.S. nonprofit hospital systems to discuss overhauling health care for veterans, including by allowing them to more readily visit hospitals outside the Veterans Affairs system. The group weighed public-private partnerships and other options that would make it possible for veterans to go to any hospital for care, inside the VA system or outside of it, a senior transition official said after the meeting. (Tracer, Pettypiece and Epstein, 12/28)

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