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KHN First Edition: July 27, 2015


First Edition

Monday, July 27, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Medicare Turns 50 But Big Challenges Await
Kaiser Health News staff writer Mary Agnes Carey reports: "Medicare, the federal health insurance program for the elderly and disabled, has come a long way since its creation in 1965 when nearly half of all seniors were uninsured. Now the program covers 55 million people, providing insurance to one in six Americans. With that in mind, Medicare faces a host of challenges in the decades to come. Here’s a look at some of them." (Carey, 7/27)

Kaiser Health News: 5 Challenges Facing Medicaid At 50
Kaiser Health News staff writer Phil Galewitz reports: "A “sleeper” provision when Congress created Medicare in 1965 to cover health care for seniors, Medicaid now provides coverage to nearly 1 in 4 Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes. Enrollment has soared to more than 70 million people since 2014 when the Affordable Care Act began providing billions to states that chose to expand eligibility to low-income adults under age 65. Previously, the program mainly covered children, pregnant women and the disabled." (Galewitz, 7/27)

Kaiser Health News: Health Law Experiment Failed To Show Savings
Kaiser Health News staff writer Jay Hancock reports: "A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money, says a new government report. The test to coordinate treatment for high-risk Medicare patients in hundreds of communities was one of many demonstrations run by the Department of Health and Human Services’ innovation center." (Hancock, 7/27)

Kaiser Health News: California Judge Likely To Dismiss Aid-In-Dying Lawsuit
Reporting for Kaiser Health News, Barbara Feder Ostrov writes: "Christy O’Donnell may not get the death she had hoped for — one that right-to-die advocates say she deserves. A California judge on Friday indicated that he will likely dismiss her end-of-life lawsuit and said he would issue his decision Monday. 'You’re asking this court to make new law,” San Diego Superior Court Judge Gregory Pollack said during a hearing Friday. “If new law is made it should be by the Legislature or by a ballot measure.'" (Ostrov, 7/27)

The Associated Press: State Health Insurance Markets Struggle With Cost Challenges
State-run health insurance markets that offer coverage under President Barack Obama's health law are struggling with high costs and disappointing enrollment. These challenges could lead more of them to turn over operations to the federal government or join forces with other states. Hawaii's marketplace, the latest cautionary tale, was awarded $205 million in federal startup grants. It has spent about $139 million and enrolled 8,200 customers for individual coverage in 2015. Unable to sustain itself, the state marketplace is turning over sign-ups to the federal for 2016. (7/26)

The Associated Press: Why The 2010 Health Care Law Led To Insurance Merger Mania
The health care overhaul law has reshaped the health insurance business, and one consequence is more than $100 billion in mergers and acquisitions over the last few years. Anthem Inc.'s purchase of Cigna Corp. and Aetna Inc.'s acquisition of Humana Inc., both announced this month, are worth more than $80 billion combined. The companies snapped up competitors in smaller, but still hefty, deals for years before that. (6/24)

The Wall Street Journal: Anthem Agrees To Buy Cigna For $48.4 Billion
The deal, combining the second- and fifth-largest health insurers by revenue, would create a company with a huge footprint in commercial insurance, the type of coverage provided to employers and consumers. ...The biggest companies are seeking more cost efficiency and scale as the health-care landscape changes because of the Affordable Care Act and other factors. Of the current major health insurers, only UnitedHealth Group Inc., the largest by revenue, has so far sat out the merger wave. (Wilde Mathews and Hoffman, 7/24)

USA Today: Are Insurer Deals Good For Consumers, Employers?
Health insurer Anthem's $54 billion deal to acquire Cigna could help keep health care costs from continuing to rise, as the insurers will have more negotiating leverage with doctors and hospitals, but the effect on employers remains unclear, say health care experts. (O'Donnell, 7/24)

Los Angeles Times: Q&A Will The Anthem-Cigna Deal Cost You Money?
Anthem Inc., California's largest for-profit health insurer, has agreed to acquire rival Cigna Corp. for $54 billion. The planned merger is the latest in a string of health insurance deals announced in the last few weeks. Aetna Inc. reached a $37-billion deal for Humana Inc. this month. And Woodland Hills insurer Health Net Inc. agreed to be acquired by Medicaid insurer Centene Corp. for $6.8 billion. (Masunaga and Terhune, 7/24)

The New York Times: New Drug Sharply Lowers Cholesterol, But It’s Costly
Federal regulators on Friday approved the first of a new class of drug that can sharply lower cholesterol levels, offering a new option for millions of Americans suffering from cardiovascular disease, the nation’s leading killer. But the drug, Praluent, which analysts project will become a huge seller, is expected to become the next flashpoint in the growing controversy of escalating pharmaceutical prices, and health plans are expected to put in place strict measures to control which patients can use the drug and prevent it from becoming a budget buster. (Pollack, 7/24)

The Wall Street Journal: FDA Approves Cholesterol Drug From Regeneron, Sanofi
The drug, called Praluent and developed by Regeneron Pharmaceuticals Inc. and Sanofi SA, provides a new and in some cases desperately needed option for several million high-risk heart patients who can’t get their cholesterol to desirable levels with the blockbuster group of medicines known as statins. But the companies are pricing the drug at $14,600 a year, an especially high amount for a medicine aimed at a common condition like heart disease. By contrast, statins, which are available in generic versions and remain the mainstay drug option for cholesterol reduction, can be purchased for just a few dollars a month. (Winslow, 7/24)

The Wall Street Journal: Teva In Talks To Buy Allergan’s Generic-Drug Unit
Israeli drug maker Teva Pharmaceutical Industries Ltd. is in talks to combine with Allergan PLC’s big generic-drug business, in a move that would further consolidation in the health-care industry and likely mean the end of Teva’s pursuit of another acquisition. (Mattioli, Rockoff, Cimilluca and Hoffman, 7/26)

Los Angeles Times: Insurers UnitedHealth, Oscar Are Poised To Join Covered California
Two new health insurers are poised to join California's market for Obamacare coverage — industry giant UnitedHealth and a New York start-up named Oscar. Many consumers may welcome the new choices starting next year and the prospect that increased competition helps hold down premiums. The lack of more health plans to choose from has been a sore point for some Covered California customers during the rollout of the Affordable Care Act. (Terhune, 7/24)

Politico: Obamacare Repeal Vote Fails In Senate
The Senate on Sunday voted down a Republican effort to repeal Obamacare, the GOP’s first attempt to get rid of the president’s health law since the party took control of the chamber in January. The effort fell 49-43, exactly along party lines, with eight senators not voting in the rare weekend session. Third-fifths of the Senate would have had to vote to add Obamacare repeal to a highway funding bill. (Haberkorn, 7/26)

The Associated Press: No Sign That Issue Of Planned Parenthood Videos Is Fading
Two stealthily recorded videos show Planned Parenthood officials discussing how they provide aborted fetal organs for research. The videos have put the group and its Democratic allies on the defensive. It’s unclear how long the political damage may last or whether Planned Parenthood has broken federal law — as abortion foes contend. What is clear is that Republicans and anti-abortion groups are giving no signs of letting the issue fade quickly. (Fram, 7/27)

Politico: GOP States Push Planned Parenthood Probes
At least eight Republican-led states are starting investigations or trying to stop funding Planned Parenthood — and they may be able to get results more easily than the outraged Republicans in Congress or on the GOP presidential campaign trail. (Haberkorn, 7/24)

The Washington Post: Long Waiting Lists For Drug Treatment Add To Addicts’ Desperation
Last month, Mercy, Maine’s largest treatment center, closed its doors and eliminated 250 beds because of declining insurance reimbursement rates. For addicts such as Cross, that leaves only the state-funded rehab program; the wait is 18 months. And a political battle over treatment funding threatens to add to addicts’ desperation in Maine: Last year, about 40 percent of heroin addicts who got treatment were put on methadone therapy. But Gov. Paul LePage (R) has proposed ending state funding for methadone treatment, saving about $1.6 million over two years. (Fisher, 7/26)

The Washington Post: Herione's Resurgence: 'And Then He Decided Not To Be’
It’s a place now ravaged by heroin — four overdoses, two of them fatal, in the past 10 months, in a town more accustomed to nothing of the kind. Maine is at the burning core of a nationwide heroin epidemic, the perverse outcome of a well-intentioned drive to save Americans from the last drug craze, a widespread hunger for heroin’s chemical cousin, prescription opiate pills such as Oxycontin. Heroin — now cheap, plentiful and more potent than ever — is killing people at record rates. Across the nation, deaths from heroin overdoses nearly quadrupled in the decade ending in 2013, according to a new analysis by the Centers for Disease Control and Prevention. (7/25)

The Washington Post: VA Whistleblowers, Punished For Revealing Excessive Opiate Use And Infestation, Are Finally Exonerated
After he reported a fly and pest infestation in the kitchen of a veterans hospital in Philadelphia, Troy Thompson was assigned to janitorial work and investigated for stealing stale sandwiches. Joseph Colon Christensen was told he was being fired after he notified Washington that the director of a dozen medical centers in Puerto Rico and the Virgin Islands was arrested. And in Tomah, Wis., Ryan Honl was stripped of his duties and locked out of his office after he disclosed that veterans were prescribed excessive prescription opiates. (Rein, 7/24)

The Wall Street Journal: Putting A Price On A Human Egg
How much is a human egg worth? The question is at the heart of a federal lawsuit brought by two women who provided eggs to couples struggling with infertility. The women claim the price guidelines adopted by fertility clinics nationwide have artificially suppressed the amount they can get for their eggs, in violation of federal antitrust laws. (Jones, 7/26)

NPR: California Judge Throws Out Lawsuit On Medically Assisted Suicide
Three terminally ill patients lost a court battle in California Friday over whether they should have the right to request and take lethal medication to hasten their deaths. San Diego Superior Court Judge Gregory Pollack said he would dismiss the case, adding that the issues were beyond his role as a judge to decide and should instead be put to the California state legislature or voters to establish new law. Plaintiffs vowed to appeal the ruling. (Dembosky, 7/24)

Los Angeles Times: UC San Diego Wins Legal Battle In Dispute With USC Over Alzheimer's Project
UC San Diego won a major legal battle Friday against USC when a judge ruled that control of a landmark project on Alzheimer's disease belongs to the La Jolla school. The decision addressed the heart of a lawsuit that has gained international attention since UC San Diego filed it early this month, largely because it's rare for such disagreements in the academic world to reach the courtroom. (Robbins, 7/24)

The Washington Post: Justice Department: Virginia Not Trying Hard Enough To Reform Programming For The Disabled
The Justice Department says Virginia is not being serious enough about efforts to comply with court-ordered reforms to its program for people with disabilities. A letter to the federal judge overseeing a 2012 federal settlement, sent by the Justice Department last month, points as evidence to the way the state has used proceeds from the sale of state-run institutions that treated people with intellectual and developmental disabilities. (Olivo, 7/25)

The New York Times: New Jersey Legislators Propose Law To Protect Nail Salon Workers
State lawmakers in New Jersey proposed legislation on Friday intended to protect nail salon workers from unhealthy working conditions and abusive labor practices. The move followed calls for reform in the industry, and the imposition of stricter rules in New York. The legislation, which was introduced by two Republican state senators, would include stronger enforcement of safety and health standards for workers in licensed nail salons, with random inspections of 5 percent of the state’s salons each year and requirements for ventilation and safety equipment. (Rojas, 7/24)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.

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