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KHN First Edition: January 23, 2017


First Edition

Monday, January 23, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Trump Stays Silent On Health Law In Speech, Then Sets Tone For Repeal
Julie Rovner reports: "Repealing and replacing the Affordable Care Act has been considered the new Trump administration’s top priority. But you wouldn’t know that from the new president’s earliest speech.President Donald Trump’s brief inaugural address mentioned many of the issues he raised repeatedly on the campaign trail — jobs, immigration and trade policy. But there was not even a brief mention of his plans to improve health care. (Rovner, 1/20)

Kaiser Health News: Doctors’ Rights To Ask About Guns Not Affected By Health Law Provisions
Michelle Andrews reports: "Should gun owners have to share information with health professionals about their firearms and whether they’re stored safely at home? This controversial issue gets a nod in the federal health law.Tucked into the Affordable Care Act is a section that protects people from having to disclose information about guns they own to wellness programs and prohibits federal health law officials from collecting and keeping records about it. Insurers can’t factor gun ownership into health insurance premiums either under this section of the law. So gun owners may want to pay attention to the debate on revising Obamacare." (Andrews, 1/20)

California Healthline: From Its Counterculture Roots, Haight Ashbury Free Clinic Morphs Into Health Care Conglomerate
Laurie Udesky reports: "Since it opened 50 years ago, the Haight Ashbury Free Medical Clinic has been a refuge for everyone from flower children to famous rock stars to Vietnam War veterans returning home addicted to heroin. Strolling through the clinic, one of the first of its kind in the nation, founder Dr. David Smith points to a large collage that decorates a wall of an exam room affectionately referred to as the Psychedelic Wall of Fame. The 1967 relic shows a kaleidoscope of images of Jefferson Airplane and other legendary counterculture bands, floating in a dreamscape of creatures, nude goddesses, peace symbols and large loopy letters." (Udesky, 1/23)

California Healthline: Drug Prices, Opioids, And Obamacare: A Conversation With Assemblyman Jim Wood
Pauline Bartolone reports: "California policymakers are facing a busy year, as a Republican-controlled Congress inches closer to rolling back key provisions of the Affordable Care Act and debate over high drug costs continues. Assemblymember Jim Wood, D–Healdsburg, helps set priorities for health policymaking as chairman of the Assembly Health Committee. The former family dentist represents a 300-mile Northern California coastal stretch that spans from Sonoma County all the way up to the Oregon border." (Bartolone, 1/23)

Reuters: Trump Order Paves Way For Agencies To Weaken Health Law
Republican lawmakers, who are working on new legislation to repeal and replace Obamacare, praised the order as showing Trump’s commitment to gutting the program and lowering steep healthcare costs they blame on the law. Trump did not specify which parts of the program would be affected by his order, and any changes are unlikely to affect the government-funded or subsidized insurance plans covering more than 20 million people in 2017. (Morgan, 1/21)

The Wall Street Journal: Donald Trump’s Health-Law Directive Spurs A Dash To Decode It
The executive order suggests the new administration intends to take swift action on its own if necessary, with a particular eye to the health law’s centerpiece requirement that most individuals buy insurance or pay a penalty. Removing that penalty would be popular in some quarters. It could also set in motion a chain of events that would hasten the collapse of the individual insurance market, and with it the health law, if no other steps were taken. Insurers losing a guaranteed customer base, while still being forced to insure sick people, could move to pull out of some markets or signal plans to dramatically increase premiums, with uncertain political consequences. (Radnofsky and Armour, 1/22)

The Washington Post: With Executive Order, Trump Tosses A ‘Bomb’ Into Fragile Health Insurance Markets
The practical implications of Trump’s action on Friday are harder to decipher. Its language instructs all federal agencies to “waive, defer, grant ­exemptions from or delay” any part of the law that imposes a financial or regulatory burden on those affected by it. That would cover consumers, doctors, hospitals and other providers, as well as insurers and drug companies. The prospect of what could flow from pulling back or eliminating administrative rules — including no longer enforcing the individual mandate, which requires Americans to get coverage or pay an annual penalty, and ending health plans’ “essential benefits” — could affect how many people sign up on the Affordable Care Act marketplaces before open enrollment ends Jan. 31 for 2017 coverage, as well as how many companies decide to participate next year. (Eilperin and Sullivan, 1/22)

NPR: Trump's Executive Order Could Dismantle Parts Of ACA Before Replacement Is Ready
Trump's order also pushes one of his favorite health care ideas — to allow insurance companies to sell policies across state lines — by encouraging "the development of a free and open market in interstate commerce for the offering of healthcare services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers." (Kodjak, 1/21)

Politico: How Trump Can Use Obamacare To Kill Obamacare
Conservatives who railed against Barack Obama's vast powers to build up the Affordable Care Act declared vindication Saturday with President Donald Trump’s executive order to tear it apart. "For me, it’s a mix of irony and schadenfreude," says Josh Blackman, a law professor who's written two books that criticized the Obama administration's implementation of the law. "I’ve warned for years that, with a new president in the White House, the exact same powers could be used for different purposes. That’s what we’re seeing now, to a T." (Diamond, 1/22)

Los Angeles Times: Here'S What Trump's Executive Order Really Means For Obamacare
Has Obamacare been repealed? In a word, no. The healthcare law was a huge piece of legislation that included scores of legal requirements and provided hundreds of billions of dollars in assistance to help extend health coverage to millions of Americans. All that can only be repealed by another law, which would require an act of Congress, not just an executive order from the president. (Levey, 1/21)

Reuters: Trump May Not Enforce Individual Health Insurance Mandate: Aide 
The Trump administration may no longer enforce a rule requiring individual Americans to carry health insurance or pay a penalty if they do not, a senior White House official said on Sunday. Speaking on ABC's "This Week" program, Kellyanne Conway, counselor to the president, said President Donald Trump "may stop enforcing the individual mandate." (Lange and Clarke, 1/22)

The New York Times: Trump’s Vow To Repeal Health Law Revives Talk Of High-Risk Pools
Joanne Fitzgerald was getting divorced and was stressed out. When stomach pain kicked in, she saw a doctor to have it checked out.That was her mistake. The doctor diagnosed a mild form of gastritis, an inflammation of the stomach lining, and recommended some over-the-counter medicine. But when the divorce became final, in 2008, she lost health coverage from her husband’s employer, and insurer after insurer refused to cover her because of the condition. She was finally offered a policy that excluded coverage for anything related to her gastrointestinal tract. (Abelson, 1/22)

The New York Times: Trump’s Health Plan Would Convert Medicaid To Block Grants, Aide Says
President Trump’s plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday. The adviser, Kellyanne Conway, who is Mr. Trump’s White House counselor, said that converting Medicaid to a block grant would ensure that “those who are closest to the people in need will be administering” the program. (Pear, 1/22)

NPR: Medicaid Block Grants Are Part Of Plan To Redo Obamacare 
"Those who are closest to the people in need will be administering it," Conway said in the interview, which was recorded the Thursday and Sunday. "You really cut out the fraud, waste and abuse, and you get the help directly to them." Medicaid is now funded by the federal government and states together and it has an open-ended funding stream, meaning it pays for all health costs to which its beneficiaries are entitled under the law. (Kodjak, 1/22)

Politico: Obamacare Chief's New Mission: Save Obamacare
Andy Slavitt’s job was to run Obamacare. Now he’s trying to save it. Slavitt stepped down on Friday as acting administrator of CMS, the sprawling federal agency that oversees the Affordable Care Act. Later that day, President Donald Trump signed an executive order that could blow much of the law apart. (Kenen and Diamond, 1/23)

The Washington Post: The Search For A Painkiller That Works Without Danger Of Addiction
When did our nation’s opioid crisis begin? Pretty much as soon as a German pharmacist isolated morphine from opium in 1805. Within the century, “addiction among soldiers was reportedly prevalent enough to earn the moniker, ‘the soldier’s disease,’ ” writes Jon Kelvey on But after more than 200 years of increased dependency and deaths, his article declares that “America’s Long-Overdue Opioid Revolution Is Finally Here.” Here’s the tantalizing prospect of the piece: New compounds may provide patients with opioid-level pain relief without the awful side effects. (Hallett, 1/22)

Los Angeles Times: The Latest Battlefront In The Abortion Wars: Regulations To Bury Or Cremate Fetuses
Over the last two years, at least five states have introduced requirements that healthcare facilities bury or cremate the remains from abortions, and in some cases also from miscarriages and stillbirths. The rules in Arkansas and North Carolina have already taken effect. Texas, Louisiana and Indiana are embroiled in lawsuits challenging their regulations, with a decision in the Texas case expected as soon as this week. (Zavis, 1/23)

The New York Times: Andrew Cuomo To Widen Access To Free Abortion And Contraception
Stepping into a period of intense anxiety over the future of the American health care system and reproductive rights, Gov. Andrew M. Cuomo plans to announce on Saturday that his administration will require health insurers to cover medically necessary abortions and most forms of contraception at no cost — essentially safeguarding protections currently afforded to women. (Yee, 1/20)

NPR: Kangaroo Care Eases Newborns' Entry Into The World
Kangaroo mother care has been widely used worldwide to care for premature babies, and it's gaining popularity in caring for healthy full term babies. It is as it sounds: Like a kangaroo's pouch, mothers hold their naked newborns on their bare chest for the first few hours of life. (Neighmond, 1/23)

The New York Times: Once A Leading Foe Of Tobacco, New York Lags Under De Blasio
In the 12 years that Michael R. Bloomberg spent as mayor of New York, he became known for pushing far-reaching health initiatives to curb smoking and change eating habits — challenging Big Tobacco, big sodas and, at times, the will of New Yorkers. The first three years of Bill de Blasio’s tenure as mayor have brought a different approach. (Neuman, 1/22)

The Washington Post: For District Workers Caring For Adult Relatives, New Legislation Is A Godsend
Tanisha Vinson, a home-health-care aide in the District, was let go from her job last month after she took off too many days to care for her mother, who had recently undergone spine surgery. “My mother was in a bed and couldn’t get out, and she called me to come,” said Vinson, a single mother of three whose son has disabilities. She missed five days of work in two weeks, and since losing her position she hasn’t found work again. (Bahrampour, 1/21)

The Washington Post: His Mental Illness Left Him Homeless. Then A Unique Program Gave Him His Life Back. 
It’s a little after noon. Usually by this hour, David Weiss would be waking for the second time, still groggy from his antipsychotics. He’d have gotten up once at dawn, maybe made himself an egg with toast. He might have gone into the back bedroom to scan his ham radio or played a few chords on his guitar. Then he’d go back to sleep. But on this day, he had somewhere to be. It’s easier to get up on days like this, days with a purpose. (Itkowitz, 1/21)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2017 Kaiser Health News. All rights reserved.

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