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KHN First Edition: July 28, 2015


First Edition

Tuesday, July 28, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: To Boost Patient Health, Rehab Sometimes Starts Before Cancer Treatment
Kaiser Health News consumer columnist Michelle Andrews writes: "Cancer patients who do rehabilitation before they begin treatment may recover more quickly from surgery, chemotherapy or radiation, some cancer specialists say. But insurance coverage for cancer “prehabilitation,” as it’s called, can be spotty, especially if the aim is to prevent problems rather than treat existing ones." (Andrews, 7/28)

The New York Times: Average Rise On Insurance Seen At 4% In California
Health insurance rates will rise next year by an average of just 4 percent in California, one of the few states that actively negotiate prices, state officials said Monday. In other states, insurers, including Blue Cross and Blue Shield, have requested rate increases of 10 percent to 40 percent or more. New customers under the Affordable Care Act turned out to be sicker than expected, many insurers have said. Some insurers reported financial losses on their exchange business, saying they paid out more in claims than they collected in premiums. (Pear, 7/27)

Los Angeles Times: Obamacare Rates To Rise 4% In California For 2016
California's Obamacare exchange negotiated a 4% average rate increase for the second year in a row, defying dire predictions about health insurance sticker shock across the country. The modest price increases for 2016 may be welcome news for many of the 1.3 million Californians who buy individual policies through the state marketplace, known as Covered California. California's rates are a key barometer of how the Affordable Care Act is working nationwide, and the results indicate that industry giants Anthem and Kaiser Permanente are eager to compete for customers in the nation's biggest Obamacare market. (Terhune, 7/27)

NPR: California Health Insurance Exchange Keeps Rate Hikes Low — Again
Monthly premiums for California's 1.3 million Covered California customers will rise a modest 4 percent, on average, officials with the agency said Monday. This increase is slightly less than last year's increase of 4.2 percent for consumers who bought policies on the state's health insurance marketplace. Some consumers could even achieve a reduction in their premium, of an average of 4.5 percent, if they choose to shop around. (Aliferis and Dembosky, 7/27)

The New York Times: Praluent Looks Cheap To Those With Extreme Cholesterol
The newly approved cholesterol-lowering drug, Praluent, is powerful almost beyond belief. It can drive levels of LDL cholesterol, the dangerous kind, into the 20s or even the teens, numbers almost never before seen in adults. In general, it lowers cholesterol by 50 percent to 70 percent, compared with 25 percent to 55 percent with statins. The $14,600 yearly price of the drug, which is injected under the skin once every two weeks, is a stunner. Yet for some patients, that might actually be a bargain. (Kolata, 7/27)

The Wall Street Journal: Patients Seeking Alternatives To Statins May Undergo Rigorous Vetting
The new drugs are expensive. And unlike a much cheaper class of pills called statins—which are proven to reduce cardiovascular risk—the jury is still out on whether the new drugs reduce serious events like heart attacks. For these reasons, many insurers plan to require rigorous evaluations before authorizing prescriptions, to make sure patients can’t get their cholesterol down with statins. An estimated 10% to 25% of people who have tried statins report having muscle pain, which limits the dose they can tolerate or precludes them from taking a statin at all. Doctors who specialize in the condition, known as statin intolerance, say by changing statins or trying other strategies, many patients initially considered intolerant can end up taking a statin after all—which is the aim of payers who plan to aggressively challenge claims of statin intolerance. (Winslow, 7/27)

USA Today: FDA Approves New Cholesterol Drug - At $14,600 A Year
Up to 10 million Americans will soon have a new option for lowering their cholesterol – at a price of $14,600 a year. The Food and Drug Administration surprised much of the medical community Friday by broadly approving a new cholesterol drug for a vast potential patient population. The agency approved Praluent for people with an inherited condition that causes very high levels of LDL, or bad cholesterol, as well as for the millions of Americans who have had heart attacks, strokes or other types of heart disease and whose LDL is higher than it should be. (Szabo, 7/27)

The Washington Post: Pentagon Gets Ready To Award Big Contract For Electronic Medical Records
The Pentagon is poised within days to award one of the most coveted health information-technology contracts in history — the first phase of a deal that could ultimately be worth more than $10.5 billon over the 18-year life of the contract. This is the first major federal IT contract since, which was so plagued by defects that hundreds of thousands of Americans were initially frustrated in trying to sign up for health insurance. The effort, designed to provide a much-needed upgrade to the current system used by 9.5 million military personnel, including active duty and retirees, is being hotly pursued by three of the heaviest hitters in private industry: Epic Systems, Cerner and Allscripts Healthcare Solutions. (Nutt and Brittain, 7/27)

Politico: Mitch McConnell Summons Restive Republicans For ‘Combative’ Sitdown
Senate Majority Leader Mitch McConnell got his hands on something he believed to be damning: An email from Sen. Mike Lee’s aide to conservative activists plotting to use an Obamacare vote as a political weapon. So McConnell quickly summoned the GOP to a closed-door session in the Senate’s Mansfield Room Monday night. ... The sitdown appeared to be an effort by McConnell to impose order in his caucus after days of infighting, initiated by Cruz, who accused McConnell of “lying” in a hard-charging series of floor speeches and public statements. Cruz, along with Lee, have sought to use arcane Senate procedures to force through simple majority votes on a range of conservative causes — to take a hard line on Iran, defund Planned Parenthood and repeal Obamacare. (Raju, 7/27)

The Washington Post: Lee Backs Down From Obamacare Amendment, After Staffer E-Mails Outside Groups
Conservative Sen. Mike Lee backed down on Monday from a controversial plan to demand a simple-majority vote to repeal Obamacare, following a meeting in which he apologized to Senate Majority Leader Mitch McConnell for the actions of a Lee staffer. Lee abandoned his plan after first offering to give up in exchange for a later repeal vote as part of budget reconciliation and failing to find support from leadership. (Snell and Kane, 7/27)

Politico: Senate Smackdown: Ted Cruz, Mike Lee Efforts Squelched By Leaders
So when Cruz came to the floor looking for at least 11 senators to agree to hold a roll-call vote, only three raised their hands. McConnell, sitting at his desk, turned around and peered at Cruz, who looked stunned at what had just happened. The Senate dispensed with his effort by a voice vote and quickly moved on, doing the same to Sen. Mike Lee (R-Utah), a Cruz ally who sought to use arcane procedures to force a vote on defunding Planned Parenthood. It all went down in an instant, but the message was clear: If Cruz doesn’t want to play nice with his Republican colleagues, they will respond in kind. (Raju and Everett, 7/27)

The Washington Post: Rand Paul Says The GOP Can Defund Planned Parenthood Before The Recess
As Congress races toward its long summer recess, Sen. Rand Paul (R-Ky.) is confident that he’ll get a vote to bar any taxpayer funds going to Planned Parenthood. “There’s a nationwide movement that we’ve been leading,” Paul said in an interview, after participating in a town hall with military veterans. “We will probably send a million emails out on this subject. I think by motivating the grassroots, there’s a very good chance we’ll get a vote on this.” (Weigel. 7/27)

The Washington Post: Planned Parenthood’s Web Site On The Defense After Hacking Claims
Planned Parenthood has been swept up in a storm of controversy in recent weeks, after an antiabortion group started to release undercover videos of officials at the organization discussing how it provides organs from aborted fetuses for research. Now, even the group’s Web site is on the defense. Hackers who say they oppose Planned Parenthood claim to have posted a database associated with the organization’s Web site as well as the names and e-mail addresses of employees online. (Ohlheiser and son, 7/27)

The New York Times: Fetal Tissue From Abortions For Research Is Traded In A Gray Zone
Videos released by an anti-abortion group during the last two weeks have drawn attention to a little-known practice: the buying, selling and research use of fetal tissue acquired from abortion clinics. The group behind the tapes accuses Planned Parenthood of selling fetal tissue for profit — which is illegal and which Planned Parenthood denies doing. House Republicans plan to investigate. This may be just one more battle in the nation’s long war over abortion, but the dispute has raised questions about who the buyers and sellers are, what fetal tissue is used for and what the law allows. (Grady and St. Fleur, 7/27)

Reuters: Teva To Buy Allergan Generic Business For $40.5B, Drops Mylan Bid
Israel's Teva Pharmaceutical Industries will pay $40.5 billion in cash and stock for Allergan's generic drugs business, solidifying Teva's position as the world's No. 1 maker of generics while freeing Allergan to focus on branded drugs, paying down debt and potential "transformational" acquisitions. The deal, the largest in Israel's corporate history, allows Teva stronger economies of scale, crucial in the low-margin generic drugs business. Teva , which dropped its hostile pursuit of Mylan, will likely have to sell off some drugs to allay antitrust concerns. (Aviv, 7/27)

USA Today: EKGs, X-Rays And Heart Procedures -- The Role Of Non-Physicians Grows
Nurse practitioners and physician assistants are a fast-growing part of the medical marketplace, getting paid more often for procedures people generally associate with doctors, such as electrocardiograms, pelvic exams and even helping with heart bypasses, a USA TODAY analysis of federal data finds. Medicare billing records show 15% more nurse practitioners and 11% more physician assistants received payments in 2013 than in 2012 for all types of care. During that same year, the number of general practice physicians paid by the insurance program for the elderly and disabled dropped by 5%. (Ungar and Hoyer, 7/27)

The Wall Street Journal's Pharmalot: UK May Require Doctors To Report Their Financial Ties To Drug Makers
U.K. doctors and public health officials may be required to report any financial ties to drug makers under plans that are being considered by U.K. government officials, The Telegraph reports. The move comes after the paper ran an undercover investigation showing how National Health Service staffers were allegedly paid by drug makers that lobby health care providers to use specific medicines. (Silverman, 7/27)

The Associated Press: Analysts Expect More Tie-Ups In Generic Drug Business
Analysts say they expect more tie-ups are coming in the generic drug industry in the wake of Teva’s mammoth deal for the generic drug business of Allergan. The Dutch drugmaker Mylan, which had resisted Teva’s advances for three months, is pressing ahead with its offer for Irish drug and ingredients maker Perrigo. Teva withdrew its offer for Mylan on Monday as it announced its alternative deal. (7/27).

The Associated Press: Experts Warn: Most Mentally Ill People Are Not Violent
Each time mental illness is cited as a possible factor in a high-profile mass killing in the United States, there’s a collective sigh among mental health professionals here. Even as they see an opportunity for serious discussions of problems and remedies, they also worry about setbacks to their efforts to destigmatize mental illness. “Most people who suffer from mental illness are not violent, and most violent acts are committed by people who are not mentally ill,” said Dr. Renee Binder, president of the American Psychiatric Association. If, hypothetically, everyone with mental illness were locked up, “you might think you were safe, but you are not,” Binder said. (7/27)

Los Angeles Times: Touches Of Home Help Venice Clinic Put Young Patients At Ease
The Lou Colen Children's Health and Wellness Center is part of a network of free clinics that have historically served uninsured patients in Los Angeles County. Though this branch — which opened in Del Rey last month — still treats many low-income families, its patient-friendly design and services reflect a shift in the way clinics across the nation are delivering healthcare. (Karlamangla, 7/27)

The Associated Press: More Illinois Residents Feel Pain As Budget Impasse Drags On
But the budget impasse is hitting a growing number of people, as social service agencies don't get promised payments, programs are reduced or eliminated and some agencies close their doors. The agencies estimate tens of thousands — most of them low-income working parents, seniors, people with disabilities and immigrants — have become the collateral damage in an ideological battle between the newly elected governor and Democrats that could go on for months. (7/27)

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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