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KHN First Edition: March 13, 2017


First Edition

Monday, March 13, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: By Law, Hospitals Now Must Tell Medicare Patients When Care Is ‘Observation’ Only
Susan Jaffe reports: "Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting observation care and why they were not admitted — even if they stay in the hospital a few nights. For years, seniors often found out only when they got surprise bills for the services Medicare doesn’t cover for observation patients, including some drugs and expensive nursing home care.The notice may cushion the shock but probably not settle the issue." (Jaffe, 3/13)

Kaiser Health News: HMO Doctors Take Pains To Slash Opioid Prescriptions
Sam Quinones reports: "On a summer afternoon in 2009, eight Kaiser Permanente doctors met in Pasadena to review the HMO’s most prescribed drugs in Southern California. Sun blasted through the windows and the room had no air conditioning, but what unsettled the doctors most were the slides a pharmacist was presenting. “We were doing so much work treating people with hypertension and diabetes, we thought those drugs would be on the list,” said Dr. Joel Hyatt, then Kaiser’s quality management director in Southern California." (Quinones, 3/13)

California Healthline: Proposed Law Would Require All California Children To Be Screened For Lead
Ana B. Ibarra reports: "Growing national concern about lead poisoning in children has prompted a California lawmaker to introduce legislation to ensure that all of the state’s kids are tested for the toxic metal. The bill, introduced by Assemblyman Bill Quirk (D-Hayward), would change the state’s Health and Safety Code to require testing for all children aged six months to 6 years." (Ibarra, 3/13)

The Associated Press: Republicans Brace For Downbeat CBO Analysis Of Health Bill
Republicans pushing a plan to dismantle Barack Obama’s health care law are bracing for a Congressional Budget Office analysis widely expected to conclude that fewer Americans will have health coverage under the proposal, despite President Donald Trump’s promise of “insurance for everybody.” House Speaker Paul Ryan said he fully expects the CBO analysis, set to be released as early as Monday, to find less coverage since the GOP plan eliminates the government requirement to be insured. (Yen, 3/13)

Politico: Budget Referee May Call Foul On Obamacare Repeal
The fate of Obamacare may lie in the hands of a number-crunching Republican appointee whose bottom line might single-handedly blow up the GOP quest to repeal and replace it. Congressional Budget Office Director Keith Hall was handpicked two years ago by top Republicans in Congress— including now Health and Human Service Secretary Tom Price — to lead a nonpartisan office that will soon release its estimate of how many Americans the Republican health care bill will cover and whether it shrinks or balloons the federal deficit. (Pradhan, 3/10)

Reuters: Agency's Analysis Of Republican Health Bill May Sharpen Resistance To Measure
House of Representatives Speaker Paul Ryan, the Republican healthcare plan's top backer in Congress, acknowledged on NBC's "Meet the Press" program on Sunday that the CBO projections would likely show a decline in insurance coverage because the legislation would drop an Obamacare provision mandating that Americans obtain health insurance or pay a fine. "The one thing I'm certain will happen is CBO will say: 'Well, gosh. Not as many people will get coverage,'" Ryan said. "You know why? Because this isn't a government mandate." (3/13)

The Washington Post: Trump Said No Americans Would Lose Coverage Under Obamacare Repeal. Paul Ryan Won’t Make That Promise.
House Speaker Paul D. Ryan (R-Wis.) said Sunday that he doesn’t know how many Americans would lose coverage under his proposal to revise the Affordable Care Act, which is under fire from fellow Republicans, AARP and virtually every sector of the U.S. health-care industry. “I can’t answer that question,” Ryan said in an appearance on CBS’s “Face the Nation.”“It’s up to people,” he said. “Here’s the premise of your question: Are you going to stop mandating people buy health insurance? People are going to do what they want to do with their lives because we believe in individual freedom in this country.” (Snell, 3/12)

The New York Times: The G.O.P.’s High-Risk Strategy For Health Law Repeal
President Trump and House Republicans are pressing forward with a high-risk strategy to repeal and replace the Affordable Care Act, disregarding the views of medical professionals and potentially imperiling the party’s political future in conservative states where many voters stand to lose their health care. The effort could cause upheaval in an already roiled insurance market next year, as Republicans face voters for the first time with Mr. Trump in the White House — though that turmoil would happen only if the plans manage to clear a divided Senate. (Pear and Kaplan, 3/11)

The Associated Press: GOP Acts Fast On Health Care, Aims To Avoid Ire Dems Faced
It took former President Barack Obama and his Democrats more than a year to pass the Affordable Care Act, a slow and painstaking process that allowed plenty of time for a fierce backlash to ignite, undermining the law from the very start. Republicans are trying to avoid that pitfall as they attempt to fulfill years’ worth of promises to repeal and replace Obama’s law. (Werner, 3/11)

The Washington Post: Sleeper Issue Of Medicaid’s Future Could Prove Health-Care Plans’ Stumbling Block
As House Republicans hurtle toward shifting the nation’s health-care system onto a more conservative path, nearly lost so far in the roiling debate over their plans is the profound impact they would have on insurance for the nation’s poorest and most vulnerable residents. The proposed American Health Care Act would break with the government’s half-century-old compact with states in helping to finance Medicaid, which covers 68 million low-income people, including children, pregnant women and those who are elderly or disabled. (Goldstein and Eilperin, 3/12)

The Wall Street Journal: Lawmakers Debate Fate Of Medicaid
The Republican push to overhaul the Affordable Care Act showed signs of bogging down Friday over the fate of Medicaid, as governors from states that expanded the program under the law faced off against conservative lawmakers who want to cut it back. Republican governors from the 16 states that expanded Medicaid intend to produce their own proposal for preserving some aspects of the Medicaid expansion, according to people familiar with the plan. It is expected to clash with a House GOP proposal that would freeze federal funding in 2020 for states that expanded Medicaid and bring other steep cuts. But the 16 governors don’t appear to be in agreement, one of these people said. (Hackman, Armour and Hughes, 3/11)

The Washington Post: GOP Infighting Over Health Care, Other Issues Belies Victory
Less than 24 hours after Donald Trump had won the White House, House Speaker Paul Ryan triumphantly proclaimed the start of a new era of Republican leadership that would “hit the ground running.” Six weeks into Trump’s administration, Republicans are running — just in different directions. As congressional leaders move forward with efforts to undo former President Barack Obama’s health care law, conservative activists and GOP lawmakers are slamming the proposal as “Obamacare lite,” ‘’Obamacare 2.0” and “RINOcare” — RINO standing for Republicans In Name Only, a term of derision. (Lerer and Beaumont, 3/13)

Politico: Conservatives Escalate Threats To Tank Obamacare Repeal
So much for President Donald Trump's charm offensive with conservatives. Conservative Hill leaders warned on Sunday that they won’t support the House GOP Obamacare alternative as it’s written, saying they’ll let the bill fail if they don’t get concessions. (Bade, 3/12)

Politico: Ryan: Disaster If GOP Health Care Reform Fails
“I believe we can get 51 votes out of the Senate,” Ryan told host John Dickerson on CBS’ “Face the Nation.” “Look, this is what the legislative process looks like. When you are going through a deliberative legislative process, not ramming and jamming things but going through all the committees, going through the entire process — people are going to try and negotiate.” Ryan downplayed the opposition to the House bill as typical “negotiations and compromises.” (McCaskill, 3/12)

Reuters: Republican Senators Wobble On House Obamacare Plan
If the Republicans' plan to dismantle most of Obamacare is approved later this month by the U.S. House of Representatives, where it cleared initial hurdles last week, it would go next to the Senate, where its fate is uncertain. At least nine Republican senators have expressed concerns about the plan, which is moving forward in the House without a clear assessment of its impact on the federal budget or how it would impact the level of health insurance among Americans. (3/13)

Politico: Another Key Republican Senator Knocks GOP Obamacare Plan
Sen. Dean Heller panned House Speaker Paul Ryan's bill to repeal and replace Obamacare during a closed meeting with constituents on Saturday, according to audio obtained by POLITICO. The remarks by Heller, the most vulnerable GOP senator on the ballot next year, are another sign of the difficult prospects the House bill faces in the other chamber. Already, more than a half-dozen senators have criticized the bill, and Republicans can afford to lose only two votes. (Everett, 3/12)

The Associated Press: Pence Appeals For Complete GOP Support For Health Overhaul
Vice President Mike Pence appealed for total GOP congressional support for a White House-backed health overhaul during a brief visit Saturday to Kentucky, where the Republican governor and junior senator are among the plan’s skeptics. “This is going to be a battle in Washington, D.C. And for us to seize this opportunity to repeal and replace Obamacare once and for all, we need every Republican in Congress, and we’re counting on Kentucky,” Pence said at an energy company where business leaders had gathered. (Thomas, 3/11)

The Washington Post: Pence Relies More On Charm Than Oratory To Push The GOP Health-Care Plan In Kentucky
Vice President Pence was in full charm mode Saturday when he touched down here for a visit to try to sell the Republican health-care plan in a state that has a complex relationship with former president Barack Obama’s Affordable Care Act. Just a day earlier, Kentucky’s Republican Gov. Matt Bevin had told reporters that while he is eager to overhaul Obama’s health plan, he found himself skeptical of the initial Republican proposal and more in line with the views of Sen. Rand Paul (R-Ky.), who has been an outspoken opponent of the bill. (Parker, 3/11)

The Wall Street Journal: Trump Administration Officials Defend GOP Health Bill Amid Party Disagreement
Trump administration officials sought to buck up support for House Republican plans to overhaul the Affordable Care Act on Sunday amid vocal dissension within the party about the measure. “We strongly support the plan,” Health and Human Services Secretary Tom Price said on NBC’s Meet the Press, adding it would bring coverage to more people without raising costs. “I firmly believe nobody will be worse off financially in the process that we’re going through.” (Harrison and Harris, 3/12)

Politico: Price On Obamacare Replacement: ‘Nobody Will Be Worse Off Financially’
Health and Human Services Secretary Tom Price said Sunday that “nobody will be worse off financially” after Republicans in Congress repeal and replace Obamacare. “I firmly believe that nobody will be worse off financially in the process that we’re going through, understanding that they’ll have choices that they can select the kind of coverage that they want for themselves and for their family, not [that] the government forces them to buy,” Price told host Chuck Todd on NBC’s “Meet the Press” in an interview that aired Sunday. “So there’s cost that needs to come down, and we believe we’re going to be able to do that through this system. There's coverage that’s going to go up.” (McCaskill, 3/12)

The Associated Press: Health Law’s Woes, Real Or Perceived, Drive Call For Repeal
President Donald Trump and Republican leaders say drastic action is needed because the Obama-era health care overhaul is a disaster, with soaring premiums and insurers bailing out. It’s true that major parts of the 2010 law are clearly troubled, but others are working fairly well.The risk is that the GOP’s “rescue mission” will inflict collateral damage on what’s working and cause new problems. Or that promised solutions might disappoint. (Alonso-Zaldivar, 3/12)

The Associated Press: Some Parts Of ‘Obamacare’ Are Working Fairly Well
President Donald Trump and Republican leaders say drastic action is needed because the Obama-era health care overhaul is a disaster, with soaring premiums and insurers bailing out. It’s true that major parts of the 2010 law are clearly troubled, but others are working fairly well.The risk is that the GOP’s “rescue mission” will inflict collateral damage on what’s working and cause new problems. Or that promised solutions might disappoint. (Alonso-Zaldivar, 3/13)

The Associated Press: Tax Credits Work Differently In ‘Obamacare’ And GOP Plan
Republicans hate “Obamacare,” so House GOP leaders freak out whenever their health care bill is compared to President Barack Obama’s law. But one reason some conservatives are branding the bill “Obamacare Lite” comes down to the tax credits to help consumers buy insurance. Both tax credits target people who don’t get health insurance from their employer or from the government. They are both available to people even if they don’t make enough money to owe any federal income tax. And they are both entitlement programs — if you meet the criteria, you are entitled to the benefit. (3/11)

USA Today: Hospitals Fear Obamacare Repeal May Create Financial Strain
The Republican plan to overhaul Obamacare could have a dire impact on hospital finances, some health care experts warn, creating serious concerns about patient safety and health care quality. Josh Sharfstein, a pediatrician and former top health official for the city of Baltimore and the state of Maryland, says the impact of the Affordable Care Act (ACA) goes far beyond expanding health insurance coverage to millions of Americans so they can get the treatment they need. That insurance reimbursement also helps keep hospitals afloat, he says. (O'Donnell, 3/12)

The Associated Press: Hospitals Worry About Caring For Newly Uninsured In GOP Plan
When Colorado expanded Medicaid coverage under former President Barack Obama’s health care law, the largest provider in the Denver region hired more than 250 employees and built a $27 million primary care clinic and two new school-based clinics. Emergency rooms visits stayed flat as Denver Health Medical Center directed many of the nearly 80,000 newly insured patients into one of its 10 community health centers, where newly hired social workers and mental health therapists provided services for some of the county’s poorest residents. Demand for services at the new primary care clinic was almost immediate. (Kennedy, 3/12)

The Associated Press: House GOP Health Bill Would Cut Women’s Services
Women seeking abortions and some basic health services, including prenatal care, contraception and cancer screenings, would face restrictions and struggle to pay for some of that medical care under the House Republicans’ proposed bill. The legislation, which would replace much of former President Barack Obama’s health law, was approved by two House committees on Thursday. (Jalonick, 3/10)

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