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KHN First Edition: February 28, 2017


First Edition

Tuesday, February 28, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Hospitals, Both Rural And Urban, Dread Losing Ground With Health Law Repeal
Sarah Varney reports: "More than a year ago, she lost her job at a nearby rural hospital after it closed and, as Republicans work to dismantle the Affordable Care Act, wonders whether she’ll soon be out of work again. “Many of my friends did not find jobs they love,” she said. “They’re working for less money or only part time. Some haven’t found any jobs yet, even after a year.” Now she runs the pharmacy at Perry Memorial Hospital here, warily watching the Republicans’ repeal efforts." (Varney, 2/28)

Kaiser Health News: Indiana’s Claims About Its Medicaid Experiment Don’t All Check Out
Side Effects Public Media's Jake Harper reports: "Indiana expanded Medicaid under the Affordable Care Act in 2015, adding conditions designed to appeal to the state’s conservative leadership. The federal government approved the experiment, called the Healthy Indiana Plan, or HIP 2.0, which is now up for a three-year renewal. But a close reading of the state’s renewal application shows that misleading and inaccurate information is being used to justify extending HIP 2.0." (Harper, 2/28)

Kaiser Health News: Advocates Of Flat-Fee Primary Care See Opening In GOP’s Market-Driven Approach
Michelle Andrews reports: "Back in the day, people paid for routine primary care on their own and used insurance only when something serious came up. Some primary care doctors are betting that model can thrive again through a monthly subscription for routine care and a high-deductible insurance policy to take care of the big stuff.But the changes raise questions about whether the approach really leads to more effective and efficient health care." (Andrews, 2/28)

Kaiser Health News: For Some Hospice Patients, A 911 Call Saves A Trip To The ER
Charlotte Huff reports: "Her mother’s breathing had become labored in the wee hours of the night, during what would prove to be the Fort Worth woman’s final days living with lung cancer. Distraught, the daughter called 911.“Her mother was having some pretty severe shortness of breath,” said Tim Gattis, the third paramedic to arrive on scene late last year. “She was certainly working very hard to obtain a breath, and was just not being successful.” (Huff, 2/28)

The New York Times: Trump Concedes Health Law Overhaul Is ‘Unbelievably Complex’
President Trump, meeting with the nation’s governors, conceded Monday that he had not been aware of the complexities of health care policy-making: “I have to tell you, it’s an unbelievably complex subject. Nobody knew that health care could be so complicated.” The president also suggested that the struggle to replace the Affordable Care Act was creating a legislative logjam that could delay other parts of his political agenda. (Pear and Kelly, 2/27)

The Associated Press: Trump Warns Health Care System Will 'Implode' Unless Fixed
Trump said at a White House meeting with dozens of governors that he hoped to overhaul the American tax system but that was a "tiny little ant" compared to what he would need to do to remake the so-called Obamacare law. The president's first major meeting with governors comes as Congress prepares to move forward on a repeal and replacement of the health care law, one of Trump's main campaign promises. Governors have raised concerns that the changes could undermine their efforts to expand Medicaid in their states and leave them stuck with a bigger share of the health care tab. (2/27)

The Wall Street Journal: Trump Calls Health Care ‘So Complicated,’ But Vows To Replace Law
Noting the ACA’s increasing popularity, Mr. Trump said, “People hate it, but now they see that the end is coming, they say, ‘Oh, maybe we love it.’ There’s nothing to love, it’s a disaster, folks, OK? So you have to remember that.” The comments came at a pivotal moment in Republicans’ efforts to undo the ACA after seven years of decrying it as a government takeover of health care. (Radnofsky, Mathews Wilde and Hackman, 2/27)

Reuters: Trump Seeks Help Of Insurers To Smooth Obamacare Transition
President Donald Trump sought on Monday to bring the nation's largest insurance companies on board with his plans to overhaul Obamacare, saying their help was needed to deliver a smooth transition to the Republicans' new plan. "We must work together to save Americans from Obamacare – you people know that and everyone knows that - to create more competition and to bring down prices substantially," Trump told insurers at a meeting at the White House. (2/27)

The Washington Post: Trump Urges Insurers To Work Together To ‘Save Americans From Obamacare’
The meeting included leaders from Blue Cross Blue Shield, Cigna, Humana, UnitedHealth Group, Aetna, Anthem, Kaiser Permanente and the industry lobbying group, America's Health Insurance Plans. "We must work together to save Americans from Obamacare," Trump said in public remarks before the closed-door meeting. The remarks came shortly after Trump lambasted the health-care law at the National Governors Association, telling the audience that health care was "an unbelievably complex subject." (Johnson and Eilperin, 2/27)

The Associated Press: Pressure On GOP To Revamp Health Law Grows, Along With Rifts
President Donald Trump declared Monday that "Nobody knew that health care could be so complicated." Yet the opposite has long been painfully obvious for top congressional Republicans, who face mounting pressure to scrap the law even as problems grow longer and knottier. With the GOP-controlled Congress starting its third month of work on one of its marquee priorities, unresolved difficulties include how their substitute would handle Medicaid, whether millions of voters might lose coverage, how their proposed tax credits would work and how to pay for the costly exercise. (2/27)

Politico: Trump's Speech Can't Mend GOP Schisms On Obamacare
President Donald Trump may rally Republicans on a strategy to repeal and replace Obamacare in his speech to Congress Tuesday night. But the reality is his administration still has to contend with huge divisions within the GOP that have turned its top policy goal into a long and uncertain slog. Republicans lack consensus on such basic questions as how much to spend to reshape the health system, how much financial help to give Americans to buy insurance and how to come up with the money to pay for it all. (Haberkorn, 2/28)

The Washington Post: Trump Touts Spending Plan, But Promise To Leave Entitlements Alone Puts GOP In A Quandary
President Trump is preparing a budget that would fulfill some of his top campaign promises by boosting military spending while cutting domestic programs. But his reluctance to embrace cuts to entitlement programs could lead to sharp tensions with Republicans in Congress who have long argued that Medicare and Social Security must be overhauled to ensure the government’s fiscal health. (Phillip and Snell, 2/27)

The Wall Street Journal: Former Governor Who Embraced Health Law To Rebut Trump’s Speech
Democrats chose a former red-state governor known for embracing the Affordable Care Act to offer rebuttal Tuesday night to President Donald Trump’s first address to Congress. Former Kentucky Gov. Steve Beshear, who left office in December 2015, is barely known outside his home state and doesn’t represent the populist bent in today’s Democratic politics. But he does come with a résumé entry important to the party’s current identity: He made Obamacare popular. (Epstein, 2/27)

The Associated Press: Plan To Repeal Obama Health Law Shows GOP Governors Are Torn
The nation’s governors don’t want people in their states to lose health coverage under a repeal of the Obama-era health care law, but even after a weekend of bipartisan meetings, they still don’t agree on the best approach to replace it. Governors attending the winter meeting of the National Governors’ Association met Monday morning with President Donald Trump at the White House, where the president marveled about the intricacies of health policy. (Nuckols, 2/27)

Politico: Trump Giving Lawmakers Whiplash On Obamacare
President Donald Trump is giving Washington a case of whiplash when it comes to his plan for Obamacare, saying one moment that he’s going to kill it and replace it with something “great” and then publicly flirting with letting it implode the next. Whether the White House can repeal and replace the law this spring — as Capitol Hill leaders say is the goal — largely depends on the president's ability to focus and outline the specifics of what he would like, while convincing reluctant GOP members to back a plan. So far, his rhetoric has been all over the place, offering differing timelines and ideas, depending on the venue and the person he's speaking with. (Dawsey and Haberkorn, 2/27)

The Associated Press: Divided Republicans Await Guidance From Trump
Congressional Republicans are hoping for clarity from President Donald Trump on key issues like health care when he delivers his first speech to a joint meeting of Congress. It comes as Republicans are discovering, a month into Trump's administration, how difficult it will be to make good on their many promises now that they control Washington in full. (2/28)

The Wall Street Journal: House Republicans Expect Trump Will Get On Board With Medicare, Social Security Cuts
House Republicans, confronted with President Donald Trump’s opposition to curbing spending on Medicare and Social Security, said Monday they were optimistic Mr. Trump would change his mind once he looks more closely at the longer-term numbers. White House officials said Monday that Mr. Trump will seek to increase military spending by 10% above budget caps set into law for next year, offset by cuts to nondefense spending, in his first budget proposal next month. (son, 2/27)

The Wall Street Journal: Disagreement In GOP Over Tax Credits To Replace Obamacare
An influential conservative House Republican said Monday he could not currently support House GOP leaders’ plan for repealing and replacing the Affordable Care Act, highlighting the internal divisions hindering Republicans as they struggle to overhaul the 2010 health-care law. Rep. Mark Walker (R., N.C.), chairman of the Republican Study Committee, said in a statement Monday night that House Republicans’ plan to repeal the ACA and replace it with a different system of individual tax credits has “serious problems” and that in its current form he could not recommend supporting it to other lawmakers in his group. The RSC had more than 170 members last year. (son and Armour, 2/27)

Politico: GOP Conservatives Oppose Leaked Obamacare Plan
House and Senate conservatives are rebelling against a leaked draft of an Obamacare replacement bill, potentially stopping the proposal in its tracks before it's even been officially introduced. On Monday, key conservative leaders huddled to discuss how to react to the House GOP's plan, which would roll back much of Obamacare's Medicaid expansion and replace subsidies for Obamacare's insurance exchanges with tax credits. And one after another, they came out in opposition to the plan, culminating in a joint statement from three senators intended to demonstrate the proposed bill cannot pass the Senate. (Everett and Bade, 2/27)

The Washington Post: Amid GOP Discord, Schumer Predicts Health-Care Law ‘Will Not Be Repealed’
The top Democratic senator predicted Monday that Republicans will fail to fulfill their long-stated goal of repealing and replacing the federal health-care law, as he went on the attack against President Trump on the eve of his first address to a joint session of Congress. Speaking at a question-and-answer session at the National Press Club, Sen. Charles E. Schumer (D-N.Y.), along with House Minority Leader Nancy Pelosi (D-Calif.), pointed to widespread disagreement among Republicans about how to go about undoing key parts of the law, as well as intense pressure from constituents urging them not to rush ahead with their effort. (Sullivan, 2/27)

Los Angeles Times: The Political Time Bomb At The Heart Of Republican Obamacare Alternatives: Higher Costs For More Americans
Republicans came into office this year promising to rescue Americans from rising healthcare bills by repealing and replacing the Affordable Care Act. But the party’s emerging healthcare proposals would shift even more costs to patients, feeding the very problem GOP politicians complained about under Obamacare. And their solutions could hit not only Americans who have Obamacare health plans, but also tens of millions more who rely on employer coverage or on government health plans such as Medicaid and Medicare. (Levey, 2/28)

The Washington Post Fact Checker: Rep. Marsha Blackburn’s False Claim That Two Key Obamacare Elements Are ‘Republican Provisions’
Among the most popular parts of the Affordable Care Act, passed in 2010 with zero votes from Republican lawmakers, are provisions that prohibit insurance companies from denying coverage based on a preexisting condition and requiring that adult children up to the age of 26 can be carried on their parents’ health plan. As Republicans craft a replacement for Obamacare, many have suggested that these ideas will be carried forward. Yet we were surprised when we saw that, in response to a question about whether these provisions would be in the replacement, Rep. Marsha Blackburn told people in her district that these were actually “two Republican provisions which made it into the [Obamacare] bill.” (Kessler, 2/28)

NPR: This CEO's Small Insurance Firm Mostly Turned A Profit Under Obamacare. Here's How
Some large health insurance companies have suffered losses under the Affordable Care Act, leading to a few high-profile exits from the health exchanges. Humana is just the latest, announcing in January that it will stop offering health insurance on the Affordable Care Act exchanges at the end of 2017.But the administrators of a smaller, California-based insurer — Molina Healthcare — managed to turn a modest profit in the early years of the health law. How did they do it? (Dembosky, 2/28)

Politico: Fears Over Pre-Existing Conditions Haunt Obamacare Debate
Republican lawmakers will resume work on an Obamacare replacement plan this week after facing anxious hometown crowds who fear losing guaranteed coverage for people with pre-existing conditions. GOP lawmakers have vowed their replacement plan will keep the requirement that insurers accept everyone regardless of potentially costly medical conditions. But the Republican proposals would be different than Obamacare in a key respect: They would allow insurers to charge more to sick people who had been uninsured right before trying to enroll in a new plan. (Haberkorn, 2/27)

USA Today: Hospitals Increasingly Try To Keep Patients Away To Save Money
Asked about his health issues, Anthony Tramonte of New Castle, Del., says, “Do you have about an hour? ”It's no wonder: The former postal worker, 72, is on dialysis, has diabetes, heart disease, high blood pressure and eye problems. He's been hospitalized three times for heart failure in the last few years and was blind for awhile due to his diabetes. (O'Donnell, 2/24)

The Wall Street Journal: Trump Slow To Submit Nominations For Top Administration Posts
President Donald Trump wants to overhaul the tax code, replace the national health-care system and roll back regulations on most major industries. He faces at least one immediate obstacle: There is no one there to help him do it. Of 549 key administration positions that require Senate confirmation, just 15 of Mr. Trump’s picks have been confirmed, while an additional 18 await confirmation. For 516 of the positions—or 94% of the total—the White House hasn't yet nominated a candidate, according to the Partnership for Public Service, a nonprofit group that works with the White House and campaigns to professionalize the transfer of power between administrations. (Ballhaus, 2/28)

The Associated Press: VA Pledges More Inspections, Drug Tests To Stem Opioid Theft
The Department of Veterans Affairs said Monday it would boost employee drug testing and inspections amid rising cases of opioid theft and missing prescriptions, acknowledging gaps that had allowed thousands of doctors, nurses and other staff to go unchecked for signs of illicit drug use. (2/27)

The Washington Post: Attorney: VA Should Have Diagnosed Client’s Cancer Sooner
A lawyer for a military veteran opened a medical-negligence trial Monday by saying his client’s now-terminal prostate cancer would have been curable had the Veterans Administration hospital in Phoenix diagnosed it sooner. Attorneys defending the Veterans Administration countered that a nurse practitioner involved in the case of Steven Harold Cooper complied with the applicable standard of care and the then-40-year-old Cooper was not considered to be at risk from prostate cancer at the time of his first appointment. (Billeaud, 2/27)

The New York Times: Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O. Says
The World Health Organization warned on Monday that a dozen antibiotic-resistant “superbugs” pose an enormous threat to human health, and urged hospital infection-control experts and pharmaceutical researchers to focus on fighting the most dangerous pathogens first. The rate at which new strains of drug-resistant bacteria have emerged in recent years, prompted by overuse of antibiotics in humans and livestock, terrifies public health experts. Many consider the new strains just as dangerous as emerging viruses like Zika or Ebola. (McNeil, 2/27)

The Washington Post: These 12 Superbugs Pose The Greatest Threat To Human Health, WHO Says
The World Health Organization announced its first list of antibiotic-resistant “priority pathogens” on Monday, detailing 12 families of bacteria that agency experts say pose the greatest threat to human health and kill millions of people every year. The list is divided into three categories, prioritized by the urgency of the need for new antibiotics. The purpose is to guide and promote research and development of new drugs, officials said. Most of the pathogens are among the nearly two dozen antibiotic-resistant microbes that the U.S. Centers for Disease Control and Prevention warned in a 2013 report could cause potentially catastrophic consequences if the United States didn't act quickly to combat the growing threat of antibiotic-resistant infections. (Sun, 2/27)

The Washington Post: CDC Biosafety Lab Air Hoses Were Not Certified For Breathable Air
The Centers for Disease Control and Prevention announced on Feb. 17 that it had temporarily suspended work at its most secure biosafety lab that handles dangerous pathogens because air hoses that are part of the required full-body protective suits worn by lab workers were not certified for breathable air. About 100 employees have worked in the labs, at CDC’s Atlanta headquarters, since the air hoses were introduced in 2008. There is no evidence that any of the employees were exposed to infectious agents or to hazardous material from breathing air through the hoses, said Stephan Monroe, CDC’s associate director for laboratory science and safety. (Sun, 2/27)

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