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KHN First Edition: September 22, 2017

KHN

First Edition

Friday, September 22, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Narrow Networks Get Even Tighter When Shopping For Mental Health Specialists
If you’ve got a plan offered on the federal health law’s insurance marketplace and you’re looking for a therapist, you may have to look really hard: The average provider network includes only 11 percent of all the mental health care providers in a given market, according to a recent study. An average marketplace plan’s network, the study added, includes just under a quarter of all psychiatrists  and 10 percent of all non-physician mental health care providers. Non-physician mental health care providers included psychologists, nurse practitioners and physician assistants, and  behavioral specialists, counselors and therapists with master’s or doctoral degrees. (Andrews, 9/22)

Kaiser Health News: Uncertainty Over Health Care’s Future Hobbles Entrepreneurs
Stinson Dean is used to taking risks. The entrepreneur from Independence, Mo., says coping with the ups and downs of the market is an inevitable part of his business. But when he started his company about a year and a half ago, he laid down a firm rule. “One of the things I wasn’t willing to risk was the health of my family,” Dean said. (Smith, 9/22)

California Healthline: A Nail-Biter: California Nervously Awaits U.S. Senate’s Verdict On Obamacare
Congressional Republicans are giving repeal of Obama’s signature health law one more try. They have until the end of the month to garner enough votes to pass the so-called Graham-Cassidy bill, which would fundamentally change how health care is funded nationwide. Its effects would be especially far-reaching in California and other states that bought heavily into the Affordable Care Act. (9/21)

California Healthline: FDA Approves Scope With Disposable Part Aimed At Reducing Superbug Infections
Seeking to prevent superbug outbreaks, federal health officials said they have approved the first gastrointestinal medical scope with a disposable cap for use in the U.S. The Food and Drug Administration said that the design of the new duodenoscope by Japanese device maker Pentax should make it easier to remove dangerous bacteria that can become trapped inside these reusable instruments. (Terhune, 9/22)

The New York Times: Latest Obamacare Repeal Effort Is Most Far-Reaching
For decades, Republicans have dreamed of taking some of the vast sums the federal government spends on health care entitlements and handing the money over to states to use as they saw best. Now, in an 11th-hour effort to repeal the Affordable Care Act, the party has come up with a way to repackage the funding for the law it loathes into a trillion-dollar pot of state grants. The plan is at the core of the bill that Senate Republican leaders have vowed to bring to a vote next week. It was initially seen as a long-shot effort by Senators Lindsey Graham and Bill Cassidy. But for all its ad hoc, last-minute feel, it has evolved into the most far-reaching repeal proposal of all. (Zernike, Abelson and Goodnough, 9/21)

The Wall Street Journal: Q&A: How The Graham-Cassidy Plan Would Change Health Coverage
The Graham-Cassidy bill would lump together the money spent on two ACA programs to expand health coverage: subsidies for private insurance and an expansion of the Medicaid program. That funding would be redistributed as block grants to states that could use it to fashion their own health systems. All of the bill’s health spending would end in 2027 and need to be reauthorized by Congress. The bill also makes structural changes to Medicaid by capping how much federal money states can get. A similar proposal, contained in the Republicans’ last effort to repeal parts of the ACA, would have resulted in 15 million people losing health coverage in a decade, according to the Congressional Budget Office. (Hackman, 9/21)

The Washington Post: How Many With Preexisting Conditions Would Be Priced Out Of Coverage Under Cassidy-Graham?
The easiest way to understand the debate over preexisting conditions in health-care coverage — a debate fueled this week by Jimmy Kimmel’s repeated disparagement of the new Republican plan to overhaul Obamacare — is to look at the Obamacare website. As of writing, Healthcare.gov explains what protections the Affordable Care Act provides to those with conditions that, before the bill’s passage, may have resulted in denial of coverage or sharply increased premiums. (Bump, 9/21)

Politico: Last-Ditch Obamacare Repeal Bill Has ‘Worst Elements’ Of Earlier Plans 
The last-ditch Obamacare repeal bill has almost every divisive proposal that doomed previous bills. The big difference: a Sept. 30 deadline to use a rule that allows Senate Republicans to pass a measure with just 50 votes. (Demko, 9/21)

The New York Times: The G.O.P. Bill Forces States To Build Health Systems From Scratch. That’s Hard.
In 2003, health care policy makers in Massachusetts agreed that the state should build a system to expand coverage to its uninsured residents. It took four years before Romneycare was fully up and running. In between, politicians had to think hard about how they wanted the system to work: how money would be raised and spent, what benefits would be offered, whether and how markets should be used to distribute coverage, whether people who didn’t buy coverage should be penalized. (Sanger-Katz, 9/21)

The Washington Post: Federal Estimate Shows Big Win-Loss Gap Among States Under Cassidy-Graham Bill
An internal analysis by the Trump administration concludes that 31 states would lose federal money for health coverage under Senate Republicans’ latest effort to abolish much of the Affordable Care Act, with the politically critical state of Alaska facing a 38 percent cut in 2026. The report, produced by the federal Centers for Medicare and Medicaid Services, focuses on the final year of a block grant that states would receive under the Cassidy-Graham legislation. It shows that government funding for such health insurance would be 9 percent lower overall in 2026 under the plan than under current law. (Goldstein and Eilperin, 9/22)

NPR: Latest Senate Health Bill Would Cut Funds To Blue States
Senate Republicans' latest plan to overhaul the U.S. health care system ends with a massive shift of federal money from states that expanded Medicaid — and are largely dominated by Democrats — to those that refused to expand. Several analyses of the bill show the pattern. (Kodjak, 9/21)

The Hill: Which States Could Win And Lose From The New ObamaCare Repeal Bill
The ObamaCare repeal bill set for a possible vote next week in the Senate would create winners and losers among the 50 states that would be asked to implement their own health-care plans with block grants of federal funding. The bill, sponsored by Republican Sens. Lindsey Graham (S.C.) and Bill Cassidy (La.), ends federal funding for ObamaCare’s Medicaid expansion and the subsidies that help people afford coverage, as well as the law’s insurance mandate. (Hellmann and Weixel, 9/21)

The Hill: GOP ObamaCare Repeal Takes New Step In Nixing Medicaid Expansion
The Senate GOP's last-ditch effort to repeal ObamaCare goes farther than past bids to rein in the law’s Medicaid expansion, barring states from extending the expansion past 2019 even if they use their own money. An earlier GOP repeal bill would have let states keep the program, but that is eliminated under the legislation crafted by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), which could come up for a Senate vote next week. (Sullivan, 9/21)

The Washington Post: Cassidy-Graham Bill Provision Would Exempt Alaska, Montana From A Cap On Medicaid Spending
As GOP leaders continue to drum up support for the health-care proposal written by Republican Sens. Bill Cassidy (La.) and Lindsey O. Graham (S.C.), a provision buried deep in the 140-page bill benefiting Alaska has begun to draw greater scrutiny. Beginning on page 95, the bill has a provision that exempts low-density states whose block grants either decrease or stay flat between 2020 and 2026 from the Medicaid per capita cap. Under that scenario, Alaska and Montana would be exempted from the funding cap that applies to all other states during that period. (Eilperin, 9/21)

The Hill: Graham And Cassidy Go Into Overdrive To Win Murkowski Vote
Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) are going into overdrive to win over Alaska Sen. Lisa Murkowski (R), a pivotal vote for their bill to dismantle ObamaCare and give states more authority over healthcare. The two have seen Murkowski, one of three Republicans to sink the GOP’s last repeal bill, as a critical vote for some time. (Bolton, 9/22)

The Hill: Pence Urges Alaskans To Contact Murkowski, Sullivan For Repeal Bill
Vice President Pence urged Alaska residents on Thursday to contact the state's Sens. Lisa Murkowski and Dan Sullivan, who are among the Republicans undecided on the new ObamaCare repeal plan, and ask them to support the bill. Pence said in an interview with Anchorage radio host Mike Porcaro that "now is the time to reach out to Sen. Dan Sullivan and Sen. Lisa Murkowski and let them know that you'd be grateful if they'd stand with President Trump and they'd vote in favor of Graham-Cassidy when it comes to the Senate floor next week." (Delk, 9/21)

Politico: Trump Publicly Backs Healthcare Effort, Privately Harbors Doubts
In public, President Donald Trump is all-in on the Senate’s final chance to repeal Obamacare. But privately, there’s ambivalence in the White House about the bill’s contents and its chances of clearing the tightly divided chamber next week. Trump spent time between meetings at the United Nations calling senators and other senior White House officials about the Graham-Cassidy bill, asking for updated vote tallies and how to woo senators for the bill. White House officials have considered tweaking the state funding to win a vote from GOP Sen. Lisa Murkowski of Alaska — and others. Trump has also publicly excoriated Kentucky Sen. Rand Paul for voting against the legislation, telling aides he would go after other senators. (Dawsey and Everett, 9/22)

Politico: McConnell Lays It On The Line
He's been battered by President Donald Trump and had his vaunted legislative acumen called into question. Now, Mitch McConnell has a chance to put his cruel summer behind him. Over the next week, the Senate majority leader will try one last time to rescind the Democratic health care law. At the same time, he's put his political reputation on the line in Alabama, where his chosen candidate, incumbent Sen. Luther Strange, faces off against anti-establishment Roy Moore in a special Senate election on Tuesday. (Everett and Bresnahan, 9/21)

The Associated Press: Iowa Sen. Ernst Hopes, But Isn't Sure, Health Bill Has Vote
Republican Sen. Joni Ernst said Thursday she isn't sure her party's last-ditch effort to repeal Barack Obama's health care law has the votes to pass, as she faced tough questions from Iowa constituents about the political drive for the measure. "If it's brought up, I hope we have the votes to pass it," Ernst told reporters after a meeting with constituents in northern Iowa. "I hope there's consensus on the bill." (9/21)

The Hill: Nevada GOP Gov Rips ObamaCare Repeal Bill: Flexibility It Promises 'A False Choice'
Nevada Gov. Brian Sandoval (R) on Thursday amped up his criticism of the new plan to repeal and replace ObamaCare, saying the GOP bill would “pit Nevadans against each other.” “Flexibility with reduced funding is a false choice,” Sandoval said in a statement to The Nevada Independent. “I will not pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers, or any other Nevadan against each other because of cuts to Nevada’s healthcare delivery system proposed by the Graham-Cassidy amendment.” (Carter, 9/21)

The Hill: Medicaid Directors Issue Warning On New ObamaCare Repeal Bill
The National Association of Medicaid Directors (NAMD) warned Republicans on Thursday that the Senate's latest ObamaCare repeal bill would place a massive burden on states. The bill, sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), would eliminate ObamaCare's Medicaid expansion and subsidies beginning in 2020, converting the funding to state block grants. (Hellmann, 9/21)

The New York Times: Jimmy Kimmel Accused A Senator Of Lying About His Health Care Bill. Who’s Right?
Jimmy Kimmel, the talk show host who has become the unlikely face of opposition to Senate Republicans’ latest health care push, insisted he had done his homework. Mr. Kimmel spent a second straight night arguing against the proposal on Wednesday. Senator Bill Cassidy of Louisiana, a co-sponsor of the bill, responded by telling news outlets that “Jimmy doesn’t understand.” (Qiu and Victor, 9/21)

The Associated Press Fact Check: Kimmel’s Take On Health Care Harder To Refute
Who’s right — President Donald Trump and Sen. Bill Cassidy, or late-night host Jimmy Kimmel? None has really captured the complexity of the debate over who might lose insurance protections in the latest Republican health care bill. But of the three, the TV guy is the hardest to refute. Trump insists in a tweet that the bill covers pre-existing conditions, a point also made by Cassidy, a sponsor of the legislation. But there’s a catch. It allows states to get a waiver from “Obamacare” requirements that insurers charge the same to people with health problems as they do to healthy people. (Alonso-Zaldivar, 9/22)

The Associated Press: Jimmy Kimmel Transforms Debate, And Shows Comedy's New Role
If the latest Republican attempt to repeal Obamacare doesn't work, it may become known as the Jimmy Kimmel Non-Law. The comic's withering attacks this week have transformed the debate over the bill (sponsored by Sens. Lindsey Graham and Bill Cassidy) and, in the process, illustrated how thoroughly late-night talk shows have changed and become homes for potent points of view. (9/21)

Politico: Kimmel Tells Viewers: ‘We Have Until Sept. 30’ To Stop GOP Health Bill
Jimmy Kimmel on Thursday said it’s not his job to talk about health care — but he’s doing it anyway, until Senate Republicans’ last-ditch bill to repeal Obamacare is stopped. “I should not be the guy you go to for information on health care,” the late-night TV host said on Thursday’s show. “And if these guys … would tell the truth for a change, I wouldn’t have to.” (Diamond, 9/21)

The Hill: Jimmy Kimmel Becomes Thorn In The GOP's Side
Republicans racing against the clock to repeal ObamaCare are fighting against Democrats, angry patient advocates and a who’s-who of health industry groups. Yet one of the most formidable opponents they face is an unlikely wild card: the comedian Jimmy Kimmel. (Lillis, 9/21)

The Hill: CNN To Host Health-Care Debate With ObamaCare Repeal Sponsors
CNN will host a town hall-style debate Monday night where senators will face off over the new ObamaCare repeal bill. The network announced that Sens. Bernie Sanders (I-Vt.) and Amy Klobuchar (D-Minn.), opponents of the bill, will debate its co-sponsors, Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.). (Concha and Sullivan, 9/21)

The Washington Post: How Tom Price Decided Chartered, Private Jets Were A Good Use Of Taxpayer Money
After Tom Price was sworn in as health and human services secretary, the Georgia Republican faced an inconvenience known to millions of Americans: His flight was delayed, an aide said, and he was forced to spend hours at an airport. The delay left Price a no-show at an early public appearance his office helped plan. Price knew well the pain of flying to and from Washington as a member of Congress for 12 years. But now he was the head of a trillion-dollar federal agency and one of President Trump’s point men to fulfill the campaign promise of repealing the Affordable Care Act. Flight delays and no-shows would not do. (Davis, 9/22)

Politico: Price Traveled By Private Plane At Least 24 Times
Health and Human Services Secretary Tom Price has taken at least 24 flights on private charter planes at taxpayers’ expense since early May, according to people with knowledge of his travel plans and a review of HHS documents. The frequency of the trips underscores how private travel has become the norm — rather than the exception — for the Georgia Republican during his tenure atop the federal health agency, which began in February. The cost of the trips identified by POLITICO exceeds $300,000, according to a review of federal contracts and similar trip itineraries. (Pradhan and Diamond, 9/21)

Stat: HHS Hints At Major Changes To Medicare That Could Mean Higher Costs For Patients
The Trump administration is signaling it will pursue significant changes to Medicare that could put beneficiaries on the hook for higher costs. In an informal proposal on Wednesday, federal health officials hinted at several new pilot programs it may implement in the months ahead. One idea would give doctors more latitude to enter into so-called private contracts to charge Medicare beneficiaries more for certain services, if the patients were willing to pay. (Mershon, 9/21)


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