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KHN First Edition: February 16, 2017


First Edition

Thursday, February 16, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: New Rules Try To Shore Up Individual Health Insurance Market In 2018
Julie Rovner reports: "While Congress continues to struggle with how to “repeal and replace” the Affordable Care Act, the Trump administration today unveiled its first regulation aimed at keeping insurers participating in the individual market in 2018.“ These are initial steps in advance of a broader effort to reverse the harmful effects of Obamacare, promote positive solutions to improve access to quality, affordable care and ensure we have a health system that best serves the needs of all Americans,” Tom Price, secretary of the Department of Health and Human Services said in a Twitter message. (Rovner, 2/15)

California Healthline: An Alzheimer’s ‘Tsunami’ Threatens Latinos
Heidi de Marco and Ana B. Ibarra report: "The number of Alzheimer’s cases is growing rapidly across the entire U.S. population, and could nearly triple by 2050 to 13.8 million, according to the Alzheimer’s Association. But the increase is particularly striking among Latinos, who as a group are at least 50 percent more likely than non-Hispanic whites to develop the disease, according to a report by the University of Southern California’s Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network. That’s in part because Latinos live longer, on average, than whites and also because they are more likely to suffer from certain chronic conditions that put them at greater risk for Alzheimer’s, the report says. Compounding the challenge, the report notes, is the fact that the elderly population is growing three times faster among Latinos." (de Marco and Ibarra, 2/16)

Kaiser Health News: How Long You Stay On Opioids May Depend On The Doctor You See In The E.R.
Jenny Gold reports: "Which doctor a person happens to see at a local emergency room can have long-term consequences when it comes to opioid use. Within the same hospital, some doctors are three times more likely to prescribe an opioid than other doctors, and patients treated by high-prescribing doctors are more likely to become long-term opioid users, according to a study published Wednesday in the New England Journal of Medicine." (Gold, 2/15)

Kaiser Health News: Travel Ban Spotlights U.S. Dependence On Foreign-Born Doctors
KERA's Lauren Silverman reports: "[Dr. Muhammad] Tauseef was born and raised in Pakistan. After going to medical school there, he applied to come to the U.S. to train as a pediatrician. It’s a path thousands of foreign-born medical students follow every year — a path that’s been around for more than half a century. And, like most foreign-born physicians, Tauseef came on a J1 visa. That meant after training he had two options: return to Pakistan or work for three years in an area the U.S. government has identified as having a provider shortage. He chose to work with mostly uninsured kids at a pediatric practice in Alexandria, La." (Silverman, 2/16)

The Associated Press: Trump Administration Ushers In Changes To Obama Health Law
The Trump administration took steps Wednesday intended to calm jittery insurance companies and make tax compliance with former President Barack Obama's health law less burdensome for some people. But the changes could lead to policies with higher annual deductibles, according to the administration's own proposal. That seems to undercut President Donald Trump's assurance in a recent Washington Post interview that his plan would mean "lower numbers, much lower deductibles." (2/15)

Reuters: Trump Administration Proposes Stricter Obamacare Rules
The Trump administration on Wednesday proposed changes to the Obamacare individual insurance market that insurers welcomed as a good start but that raised the possibility of higher out-of-pocket cost for consumers. ... The proposed new rule, issued by a division of the U.S. Department of Health and Human Services, sets out changes that are meant to shore up the system developed by Obama, and comes after Humana Inc on Tuesday said it would pull out of this market in 2018. It is unclear which elements of Obamacare could survive in the Republicans' replacement. (2/15)

The New York Times: White House Proposes New Rules To Steady Insurance Markets Under Health Law
The proposed rules, backed by insurance companies, would tighten certain enrollment procedures and cut the health law’s open enrollment period in half, in hopes that a smaller but healthier consumer base will put the marketplaces on sounder financial footing and attract more insurance companies in states with limited choices. But part of the market’s problem stems from President Trump’s determination to repeal the health law while the White House and Congress struggle to find a politically acceptable replacement. Even as the Department of Health and Human Services worked to answer insurance company concerns, the Internal Revenue Service and Congress were taking steps that could add uncertainty to the jittery insurance economy. (Pear, 2/15)

NPR: Trump Administration Proposes Obamacare Changes To Stabilize Insurance Market
HHS will also require people who want to sign up for coverage during so-called special enrollment periods to first prove they qualify because of a life change like losing a job or getting divorced. "The overall effect of many of the policies here would actually, over time, I think, actually shrink enrollment, not grow enrollment," says Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reforms. (Kodjak, 2/15)

The Wall Street Journal: Trump Administration Rule Aims To Calm Insurers During Health-Law Limbo
The proposal “is a step in the right direction,” said Alan Murray, chief executive of CareConnect, a New York insurer and a unit of Northwell Health. “It definitely doesn’t go far enough to stabilize the insurance markets.” A new exodus of insurers from the exchanges in 2018, or large rate increases, could lead to upheaval for consumers and spur a political backlash against Republicans, who will have been in charge of federal health policy for nearly a year by then. (Armour and Wilde Mathews, 2/15)

The Washington Post: IRS Won’t Withhold Tax Refunds If Americans Ignore ACA Insurance Requirement
The Internal Revenue Service has revoked an Obama-era instruction to taxpayers that was taking effect during the current filing season as a way to further compliance with the ACA’s requirement that most Americans carry health insurance or pay a tax penalty. Under the instruction, the IRS had announced that it would no longer process tax returns for people who fail to send a notice with their returns that they have insurance, are exempt from the requirement or are paying the fine. (Goldstein, 2/15)

The New York Times: Now You Can Do Your Taxes Without Filling Out The Insurance Question
If you want to keep your health insurance status a secret from the I.R.S., the Trump administration just made it a little easier. The policy change, confirmed by the I.R.S. on Wednesday after elements were reported by the libertarian magazine Reason, does not do away with the Affordable Care Act’s requirement that all Americans who can afford it obtain health insurance or pay a fine. But it might make it a little harder for the I.R.S. to figure out who is breaking the rules. (Margot Sanger-Katz, 2/15)

The Associated Press: House GOP Batting Around Options For Revamping Health Law
House GOP leaders are offering rank-and-file lawmakers options for replacing President Barack Obama's health care law. Lawmakers, aides and lobbyists say the proposals take a conservative approach dominated by tax breaks and a transition away from today's Medicaid program. House Speaker Paul Ryan and other House leaders planned to discuss details of their plans with lawmakers Thursday and gauge their receptiveness. (2/16)

The Washington Post: House GOP Leaders Will Elaborate On Their Obamacare Plans
House Majority Leader Kevin McCarthy (R-Calif.) told reporters Wednesday that committee leaders will brief GOP lawmakers on some specific proposals at a closed-door meeting scheduled for Thursday morning. The meeting comes as leaders are working to rally sharply divided GOP members around a single plan to remake the health-care law. Asked whether leaders planned to announce specific elements of the repeal-and-replace plan that will be included in upcoming legislation McCarthy said, “Yes.” McCarthy did not say which elements of the plan would be detailed at the meeting. (Snell, Weigel and DeBonis, 2/15)

The Washington Post: Freedom Caucus Backs ACA ‘Repeal And Replace’ That Counts On Private Health Care
House conservatives, frustrated by GOP leadership’s slow and tentative approach to replacing the Affordable Care Act, have gotten behind legislation by Rep. Mark Sanford (R-S.C.) and Sen. Rand Paul (R-Ky.) that would repeal most of the law and move millions of Americans Health Savings Accounts (HSAs). “We were tired of waiting,” said Rep. Jim Jordan (R-Ohio) at a Wednesday press conference on the legislation, “and that’s why we said: Let’s go. Let’s go now.” (Weigel, 2/15)

The Associated Press: 18,000 Call In To Illinois GOP Congressman's Phone Town Hall
About 18,000 callers participated in a telephone town hall hosted by U.S. Rep. Roskam, a suburban Chicago Republican who has been criticized for canceling smaller in-person meetings and declining debates. ... Roskam abruptly canceled a smaller meeting with constituents this month to hear concerns about repealing the Affordable Care Act. Protesters have since shown up to his events. The League of Women Voters has also invited him to debates and town halls, which he has declined. (2/15)

Politico: A Bleak Week For Obamacare
Obamacare’s health insurance markets are flirting with financial disaster — and that’s before Republicans have had a chance to lay their hands on the law they’ve vowed for seven years to repeal. (Demko, 2/15)

The Associated Press: Insurer Anthem Fires Back At Cigna
Health insurers Anthem and Cigna are now trading lawsuits instead of working together to salvage a shaky $48-billion buyout agreement. The Blue Cross-Blue Shield carrier Anthem said Wednesday that it is seeking a restraining order to block its smaller rival from terminating their deal, which has already been blocked by a federal judge. (2/15)

The Wall Street Journal: Anthem Counters Cigna’s Lawsuit By Filing Its Own Suit
In its suit, filed like Cigna’s in the Delaware Court of Chancery, Anthem said it sought a temporary restraining order to block Cigna from ending their pact. It also sought to force Cigna to adhere to the terms of their deal and requested damages. Anthem said it was reacting to “Cigna’s campaign to sabotage the merger and to try to deflect attention from its repeated willful breaches of the merger agreement.” (Wilde Mathews, 2/15)

The Washington Post: Aetna Chief Executive Says Obamacare Is In A ‘Death Spiral’ 
Aetna chief executive Mark Bertolini said Wednesday that the Affordable Care Act's exchanges — the marketplaces where consumers can buy individual health coverage under President Barack Obama's signature health-care law  — are in a “death spiral.” Bertolini's remarks at the Wall Street Journal's the Future of Healthcare event came a day after the official end of his company's proposed merger with the health insurer Humana — a divorce that will cost Aetna a $1 billion breakup fee. (Johnson, 2/15)

Politico: Aetna CEO: Obamacare Markets Are In A 'Death Spiral'
Bertolini’s doomsday prophesy: More insurers will pull out of the government-run marketplaces in the coming weeks and many areas will have no insurers to provide Affordable Care Act coverage in 2018. “It’s not going to get any better; it’s getting worse,” Bertolini said in an interview at a Wall Street Journal event. But he declined to say whether Aetna would completely pull out of Obamacare markets next year, though he said the population of covered people in the marketplaces has skewed older and sicker than expected. (Demko, 2/15)

Reuters: U.S. Healthcare Costs To Escalate Over Next Decade: Government Agency
The cost of medical care in the United States is expected to grow at a faster clip over the next decade and overall health spending growth will outpace that of the gross domestic product, a U.S. government health agency said on Wednesday. A report by the U.S. Centers for Medicare and Medicaid Services (CMS) cited the aging of the enormous baby boom generation and overall economic inflation as prime contributors to the projected increase in healthcare spending. (Abutaleb, 2/15)

The Associated Press: US Report: Trend Of Rising Health Care Spending Back To Stay
Wednesday's report from nonpartisan experts at Health and Human Services concludes that health care spending will claim a growing share of national resources for the foreseeable future, regardless of what President Donald Trump and Congress do with the Obama-era health law. Health care will grow at an annual average of 5.6 percent from 2016-2025, outpacing expected economic growth. Now $3.5 trillion, the nation's health care tab will increase to nearly $5.5 trillion in 2025, accounting for about one-fifth of the economy. That puts a squeeze on other priorities, such as infrastructure improvement. (2/15)

The Wall Street Journal: Growth In U.S. Health Spending Slowed Slightly In 2016
Last year saw slower growth in Medicaid, a federal-state program for low-income individuals, as well as in prescription drug spending. Both factors likely contributed to the reduced growth in overall health spending. Prescription drug spending grew 5% in 2016, compared with 9% in 2015, a shift largely be attributed to a decrease in the use of specialty drugs to treat hepatitis C. At the same time, the growth of Medicaid slowed last year as the impact of an expansion of the program under the Affordable Care Act began to wane. (Hackman, 2/15)

The Washington Post: Why America’s Health-Care Spending Is Projected To Soar Over The Next Decade
The projections are based on an assumption that the legislative status quo will prevail — an unlikely scenario given President Trump and Republicans' plan to repeal and replace the Affordable Care Act. The spending projections are similar to previous estimates, putting health care on track to make up about a fifth of the economy by 2025. (Johnson, 2/15)

The New York Times: Harvard And M.I.T. Scientists Win Gene-Editing Patent Fight
The Broad Institute in Cambridge, Mass., will retain potentially lucrative rights to a powerful gene-editing technique that could lead to major advances in medicine and agriculture, the federal Patent and Trademark Office ruled on Wednesday. The decision, in a bitterly fought dispute closely watched by scientists and the biotechnology industry, was a blow to the University of California, often said to be the birthplace of the technique, which is known as Crispr-Cas9. (Pollack, 2/15)

The Washington Post: Broad Institute Scientist Prevails In Epic Patent Fight Over CRISPR
The CRISPR patent fight appears to be over, at least for the moment. A ruling by the U.S. Patent Trial and Appeal Board found no “interference” in patents awarded to Feng Zhang at the Broad Institute of MIT and Harvard. The loser, pending appeals, is the University of California, and the much-heralded biochemist  Jennifer Doudna, who, along with Emmanuelle Charpentier, in 2012 published a groundbreaking paper showing how to exploit a natural bacterial gene-editing system known as CRISPR. The patent office determined that Zhang's later innovations, which used CRISPR to edit mammalian cells, were not simply elaborations of what Doudna and Charpentier had already discovered. (Achenback and Johnson, 2/15)

NPR: Patent Office Upholds Controversial Gene-Editing Ruling
The proceedings aren't entirely settled, but as Sherkow sees the situation, the Broad Institute — a joint venture of Harvard University and MIT — will hold the patent for using CRISPR in human beings, other animals, and plants. Sherkow told Shots he believes Cal's patent, which has not yet been issued, could be limited to bacteria. (Harris, 2/15)


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