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KHN First Edition: March 7, 2017


First Edition

Tuesday, March 07, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: House GOP Health Bill Jettisons Insurance Mandate, Much Of Medicaid Expansion
Mary Agnes Carey and Phil Galewitz report: "House Republicans unveiled their much anticipated health law replacement plan Monday, slashing the law’s Medicaid expansion and scrapping the requirement that individuals purchase coverage or pay a fine. But they opted to continue providing tax credits to encourage consumers to purchase coverage, although they would configure the program much differently than the current law." (Carey and Galewitz, 3/6)

Kaiser Health News: Dentistry Advocates Aim To Fill Medicare Gaps
Phil Galewitz reports: "Carolyn Thompson’s tight-lipped smile hides a health care problem the 81-year-old retired nurse can’t afford to correct and Medicare won’t pay for. She needs dentures. Her missing bottom teeth make chewing difficult, so she avoids hard fruits and foods that provide valuable nutrients. Thompson hasn’t seen a dentist in years, even though there’s one where she lives, in the Fair Haven retirement community here. “When I was working I always took care of my teeth, but in the last couple of years — I don’t have the money to pay for it,” said Thompson." (Galewitz, 3/6)

Kaiser Health News: ‘Right-To-Try’ Laws Expose Dying Patients To Exploitation, Ethicists Warn
KQED's Carrie Feibel reports: "In the past three years, 33 U.S. states have passed laws aimed at helping dying people get easier access to experimental treatments. Supporters say these patients are just looking for the “right to try” these treatments.Such laws may sound compassionate, but medical ethicists warn they pose worrisome risks to the health and finances of vulnerable patients." (Feibel, 3/6)

California Healthline: Are Virtual Doctor Visits Really Cost-Effective? Not So Much, Study Says
Ana B. Ibarra reports: "Consultations with doctors by phone or video conference appear to be catching on, with well over a million virtual visits reported in 2015. The convenience of “telehealth” appeals to patients, and the notion that it costs less than an in-office visit would make it attractive to employers and health plans. But a new study suggests that while telehealth services may boost access to a physician, they don’t necessarily reduce health care spending, contrary to assertions by telehealth companies." (Ibarra, 3/6)

California Healthline: Los Angeles County Finds E-Success In Managing Specialist Care
Anna Gorman reports: "An electronic program launched in 2012 by Los Angeles County’s public health care system has reduced wait times for specialty care and eliminated the need for some safety-net patients to see specialists at all, according to a new study in the journal Health Affairs. The program, eConsult, allows primary care doctors to get specialists’ advice for their patients and expedite referrals for those who need in-person appointments. About a quarter of the requests included in the study were resolved without patients needing to see an advanced-care doctor, though there was variation among the specialties. (Gorman, 3/7)

The New York Times: House Republicans Unveil Plan To Replace Health Law
The House Republican bill would roll back the expansion of Medicaid that has provided coverage to more than 10 million people in 31 states, reducing federal payments for many new beneficiaries. It also would effectively scrap the unpopular requirement that people have insurance and eliminate tax penalties for those who go without. The requirement for larger employers to offer coverage to their full-time employees would also be eliminated. People who let their insurance coverage lapse, however, would face a significant penalty. (Pear and Kaplan, 3/6)

Politico: Obamacare Repeal Bill Offers Tax Credits, Big Medicaid Changes
The House plan calls for age-based tax credits ranging from $2,000 to $4,000, replacing the Affordable Care Act's income-based subsidies. Credits for a single household would be limited at $14,000. Subsidies would be phased out for individuals earning $75,000 and at $150,000 for families. (Demko, 3/6)

USA Today: House Republicans Unveil Obamacare Replacement Bill
[The bill] would still allow adult children to stay on their parents' plans until age 26. And the bill would not repeal the popular provision barring insurance companies from denying coverage to people with pre-existing health problems. Instead, to keep people from buying coverage only when they need it, insurers could raise premiums 30% for those jumping back into the market. (Groppe, 3/6)

The Wall Street Journal: House GOP Releases Plan To Repeal, Replace Obamacare
The bill is a political gamble for House Republican leaders. The party and President Donald Trump ran for office on promises to repeal and replace the health law. Republicans have said their plan is aimed at decreasing costs and boosting choice for consumers. But to do so, their proposals would likely provide coverage for far fewer people than the ACA, according to a number of research reports. “Working together, this unified Republican government will deliver relief and peace of mind to the millions of Americans suffering under Obamacare,” said House Speaker Paul Ryan. (Armour, son and Hackman, 3/6)

Politico: GOP Unveils Obamacare Replacement Amid Sharp Party Divide
House GOP leaders have also yet to release the official budget score that details the cost of the plan and how many people could lose insurance, a huge issue for moderates who fear blowback in their swing districts. “We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services,” wrote the four Republican senators to Majority Leader Mitch McConnell (R-Ky.). Signatories included Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska—Republicans from states that expanded Medicaid under Obamacare. (Bade, Demko and Haberkorn, 3/6)

The Wall Street Journal: Top Earners Would Pay Less Tax Under GOP Health-Care Proposal
Households at the top of the U.S. income ladder would see taxes on their wages and investments drop under the House Republicans’ new health-care proposal. As expected, the bill repeals a 3.8% tax on investment income and a 0.9% tax on wages. Both levies affect only the highest-earning households, those individuals making at least $200,000 and married couples making more than $250,000. (Rubin, 3/7)

Politico: Republicans' Obamacare Repeal Plan Would Cut Taxes On The Wealthy
Though the legislation is focused on making good on Republican promises to repeal and replace the health program, it would likely also amount to the first big tax cut of the Trump administration, one that comes even before lawmakers tackle tax reform in earnest. The plan should make rewriting the tax code easier by moving the cost of some tax cuts into separate legislation. (Faler, 3/6)

The Associated Press: House GOP Releases Bill Replacing Obama Health Care Overhaul
House committees planned to begin voting on the 123-page legislation Wednesday, launching what could be the year’s defining battle in Congress. GOP success is by no means a slam dunk. In perhaps their riskiest political gamble, the plan is expected to cover fewer than the 20 million people insured under Obama’s overhaul, including many residents of states carried by President Donald Trump in November’s election. (Fram and Alonso-Zaldivar, 3/6)

The Associated Press: GOP Bill Unlikely To Settle Passionate Health Care Debate
The nation’s passionate debate about the role of government in providing health care for citizens and paying the costs is unlikely to be settled by the legislation newly revealed by House Republicans. With Republicans now controlling the White House and both chambers of Congress, the bill would drive government policy down routes long advocated by conservatives. The course correction would take at least two years to get rolling, and probably longer to show definitive results. If it falls short, it would give rise to a fresh set of health care grievances. (Alonso-Zaldivar and Fram, 3/7)

Los Angeles Times: Republicans Unveil Plan To Repeal And Replace Obamacare Amid Conflicting Pressures
[T]he bill faces opposition from many conservatives who say it does not go far enough in uprooting the current law. The bill also faces attack from some Senate Republicans who are concerned about any plan that eliminates existing Medicaid coverage. The critiques from both left and right underscore the difficulty the GOP leadership faces in pushing the bill, despite the Republican majorities in both the House and Senate. (Levey and Mascaro, 3/6)

Politico: Conservatives Pan House Obamacare Repeal Bill
A handful of House conservatives on Monday evening criticized GOP leaderships’ newly released Obamacare replacement bill, foreshadowing trouble for the repeal effort even after leaders tried to assuage the far-right. Some House Freedom Caucus members dismissed the bill as creating a new “entitlement program” by offering health care tax credits to low-income Americans. (Bade, 3/6)

NPR: Obamacare Changes Emerge In House Repeal And Replace Bill
Rep. Frank Pallone, D-N.J., and Richard Neal, D-Mass., the ranking Democrats on the Energy and Commerce and Ways and Means committee issued a joint statement saying the bill would "rip healthcare away from millions of Americans, ration care for working families and put insurance companies back in charge." (Kodjak and Neel, 3/6)

The Associated Press: Arkansas Governor Seeks New Restrictions On Medicaid Plan
Arkansas would move about 60,000 people off its hybrid Medicaid expansion and require some participants to work under a series of restrictions the governor proposed Monday, even as the future of the federal health overhaul remains murky. Republican Gov. Asa Hutchinson said he’ll ask the federal government to approve the new restrictions by June and hopes to implement them by 2018. More than 300,000 people are on Arkansas’ hybrid program, which uses Medicaid funds to purchase private insurance for the poor. The program was created in 2013 as an alternative to expanding Medicaid under the federal health law. (Demillo, 3/6)

The Washington Post: What If There’s No Affordable Insurance To Buy?
Leslie Kurtz needed three plates, eight screws and a big assist from her insurer after breaking every bone in her ankle while white water rafting. Coverage she purchased through a public insurance exchange established by the federal health care law paid $65,000 toward surgery and the care she needed after the 2015 accident. But that protection may not exist next year because insurers have abandoned the Knoxville, Tennessee resident’s exchange. As of now, Kurtz has no future coverage options, and she is worried. “I can’t afford to have everything I’ve worked for taken away because I fell down the steps,” Kurtz said. (Murphy and Hoyer, 3/6)

The New York Times: Trump Tells Planned Parenthood Its Funding Can Stay If Abortion Goes
The White House, concerned about the possible political repercussions of the Republican effort to defund Planned Parenthood, has proposed preserving federal payments to the group if it discontinues providing abortions. The proposal, which was never made formally, has been rejected as an impossibility by officials at Planned Parenthood, which receives about $500 million annually in federal funding. That money helps pay for women’s health services the organization provides, not for abortion services. (Haberman, 3/6)

USA Today: Doctors Try To Balance Care, Federal Demands
Tim Layman has high blood pressure but stopped taking medication for it more than two years ago because "it's not really for me." "I believe there is a God that supersedes that natural order," says the Rogers, Ark., pastor. "I’ve been made this way, and I’m not concerned about it." His doctor is. (O'Donnell, 6/3)

The Associated Press: Arizona Man Awarded $2.5M In Medical Lawsuit Vs VA Hospital
A judge on Monday awarded $2.5 million to a military veteran who said that his now-terminal cancer would have been curable had the Veterans Administration hospital in Phoenix diagnosed it sooner. U.S. Magistrate Judge Michelle Burns ruled a nurse practitioner who found abnormalities in Steven Harold Cooper’s prostate during an examination in late 2011 at the Carl T. Hayden VA Medical Center had breached the standard of care by failing to order more testing and refer him to a urologist. (Billeaud, 3/6)

The Wall Street Journal: Advanced Cancer Treatments Far From Big-Name Hospitals
Community health-care systems are taking steps to embrace genetic testing in treating cancer, a cutting-edge approach offered at most major academic medical centers. The changes mean patients can get treatment close to where they live. The hospitals and small practices treat most cancer patients but may be far from major research centers and have fewer resources than them. (Kincaid, 3/6)

NPR: Medical Breakthroughs Often Don't Pan Out In The Long Run
When you pick up a newspaper and read a story about the latest results on breast cancer, autism, depression or other ailments, what are the odds that finding will stand the test of time? The answer, according to a study in the journal PLOS One is: flip a coin. (Harris, 3/6)

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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