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KHN First Edition: October 16, 2017


First Edition

Monday, October 16, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Stunner On Birth Control: Trump’s Moral Exemption Is Geared To Just 2 Groups
Few people were surprised last week when the Trump administration issued a rule to make it easier for some religious employers to opt out of offering no-cost prescription birth control to their female employees under the Affordable Care Act. But a separate regulation issued at the same time raised eyebrows. It creates a new exemption from the requirement that most employers offer contraceptive coverage. This one is for “non-religious organizations with sincerely held moral convictions inconsistent with providing coverage for some or all contraceptive services.” (Rovner, 10/16)

Kaiser Health News: Podcast: ‘What The Health?’ Let’s Blow It Up
With Congress having given up on repealing and replacing the Affordable Care Act, at least for now, President Donald Trump stepped in to try to make some changes himself. On Thursday, he signed an executive order aimed at making insurance cheaper for some people, but in ways that could make it more expensive for others. (10/13)

Kaiser Health News: Trump Acting Solo: What You Need To Know About Changes To The Health Law
Apparently frustrated by Congress’ inability to “repeal and replace” the Affordable Care Act, President Donald Trump this week decided to take matters into his own hands. Late Thursday evening, the White House announced it would cease key payments to insurers. Earlier on Thursday, Trump signed an executive order aimed at giving people who buy their own insurance easier access to different types of health plans that were limited under the ACA rules set by the Obama administration. (Rovner, Carey and Appleby, 10/13)

Kaiser Health News: Facebook Live: Trump Ends Payments For Cost-Sharing Reductions. What’s Next?
President Donald Trump has followed through on a long-standing threat. His administration announced late Thursday it will halt federal payments for the Affordable Care Act’s cost-sharing reductions. This is the latest blow to the stability of the ACA’s insurance marketplaces, and it is triggering significant confusion among consumers and insurers. This live chat features KHN senior correspondent Jay Hancock answering questions about what it might mean for the upcoming open enrollment period and beyond. (10/13)

California Healthline: Impact Of Trump Subsidy Decision Blunted In California — For Now
Unable to get Congress to “repeal and replace” the Affordable Care Act, President Donald Trump this week took matters into his own hands. Late Thursday evening, the White House announced it would stop paying key subsidies, known as “cost-sharing reductions,” that compensate insurers for providing discounts on deductibles, copays and other out-of-pocket costs to low-income consumers. (Rovner, Bazar and Terhune, 10/13)

Kaiser Health News: Tending To Patients As Her New Home Burns
Julayne Smithson was working an overnight shift in the Intensive Care Unit at the Kaiser Permanente hospital in Santa Rosa, Calif., when massive wildfires started racing through the city. Smithson had no idea how close they were. She was too busy taking care of her patient. “One of the nurses came up to me and she said, ‘Julayne, I’m sorry, but your house is not going to make it,’” she said. (Dembosky, 10/16)

The New York Times: End To Health Care Subsidies Puts Congress In A Tight Spot
President Trump’s decision to cut off critical payments to health insurance companies ratcheted up the pressure on Congress on Friday to take action to protect consumers from soaring premiums, while also adding a combustible new issue to negotiations to avert a government shutdown this year. Mr. Trump’s move, announced Thursday night, could cause chaos in insurance markets, sending insurers fleeing from the Affordable Care Act’s marketplaces, raising the federal government’s costs and pricing out some consumers. (Kaplan and Pear, 10/13)

The Wall Street Journal: Health Care Back On Congress’s Front Burner
The Senate this week will grapple with President Donald Trump’s decision to stop making subsidy payments to health insurers, with lawmakers seeking a deal that would keep the money flowing while Republicans try to fold in conservative-oriented health-care priorities. It remains unclear whether a package could emerge that attracts support from a critical mass of senators and also from House Republicans. That could be put to the test quickly, as Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.) are expected to introduce a plan within days and Sen. Ron Johnson (R., Wis.) unveils his own, more-conservative-leaning version. (Armour and son, 10/15)

Politico: Congress' Uncertain Path On Obamacare Subsidy Fix
A bipartisan attempt by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) to stabilize Obamacare, which would fund the subsidies for up to two years, has already encountered skepticism from GOP conservatives and growing opposition from the White House. The two lawmakers plan to keep talking — but it's a tough road. “Under no circumstance should Congress attempt to expand Obamacare by cutting a check for President Obama's bailout of insurance companies," Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee, tweeted late Thursday. (Haberkorn and Cancryn, 10/13)

The Associated Press: Trump's 'Obamacare' Move Jolts Health Care, Political Worlds
Defiant Democrats, convinced they have important leverage, promised to press for a bipartisan deal to restore the money by year's end. That drive could split the GOP. On one side: pragmatists seeking to avoid political damage from hurting consumers. On the other: conservatives demanding a major weakening of the Affordable Care Act as the price for returning the money. "The American people will know exactly where to place the blame," declared Senate Minority Leader Chuck Schumer, D-N.Y., all but daring Trump to aggravate what could be a major issue in the 2018 congressional elections. (10/14)

The Wall Street Journal: Republicans Split Over Trump’s Move To End Health Subsidies
President Donald Trump’s decision to end payments to insurers under the Affordable Care Act triggered an immediate dispute Friday among Republicans over whether to reverse the decision and shore up the nation’s insurance markets or embrace Mr. Trump’s move. That fight is likely to intensify upon the announcement of a bipartisan deal to guarantee the insurer payments, which is expected to be released within days, according to people familiar with the talks. The deal, led by Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.), would authorize the payments Mr. Trump is ending, while also providing states some flexibility under the ACA. (son and Armour, 10/13)

The Associated Press: Collins: Trump Should Back Effort To Resume Health Subsidy
A key moderate Republican is urging President Donald Trump to support a bipartisan Senate effort to reinstate insurer payments, calling his move to halt the subsidies an immediate threat to millions of Americans who could now face rising premiums and lost health care coverage. "What the president is doing is affecting people's access and the cost of health care right now," said Sen. Susan Collins of Maine, who has cast pivotal votes on health care in the narrowly divided Senate. "This is not a bailout of the insurers. What this money is used for is to help low-income people afford their deductibles and their co-pays." (10/16)

Politico: Collins And Pelosi Disappointed That Trump Ended Obamacare Subsidies
A pair of key lawmakers on each side of the aisle criticized President Donald Trump on Sunday for ending subsidies that help low-income Americans afford health care under the Affordable Care Act. Sen. Susan Collins (R-Maine) said she was “disappointed” by the president’s actions and urged Congress to “step in” with its own plan for Obamacare. (Klimas, 10/15)

The Washington Post: Partisan Clash On Obamacare Raises Specter Of Government Shutdown
Democrats accused President Trump of trying to sabotage the nation’s health-care system through his decision to halt payments to insurers meant to shore up the system, while Republicans countered Sunday that Trump is just pushing for a hard bargain. Trump’s decision, announced Friday after months of criticizing the payments as an insurance industry bailout, will throw in doubt the private insurance exchanges that are part of the Affordable Care Act. Democrats vowed to use year-end negotiations on the federal agency budgets as a leverage point to reinstate the payments, vowing to pin the political blame on Republicans if premiums skyrocket next year. (Kane, 10/15)

The Hill: Dem Senator: Trump 'Is Setting The Entire Health Care System On Fire'
Sen. Chris Murphy (D-Conn.) on Sunday ripped President Trump's decision to end key ObamaCare payments known as cost-sharing reduction (CSR) benefits, comparing the decision to "arson." "This is the equivalent of health care arson. He is literally setting the entire health-care system on fire just because the president is upset that the United States Congress will not pass a repeal bill that is supported by 17 percent of the American public," Murphy said on "Fox News Sunday." (Manchester, 10/15)

Politico: Epic Legal Battles Shaping Up Over Trump's Scrapping Of Obamacare Subsidies
President Donald Trump's move to cut off critical Obamacare subsidies will almost surely be tied up in the courts for years as Democratic-led states seek injunctions, while insurers seek to recover payments they say they’re owed. It's impossible to predict whether a judge might order the administration to continue the payments while the lawsuits are heard, but at least some legal experts express doubts. (Demko and Pradhan, 10/13)

NPR: Swift Reaction To White House's Move To End Insurance Subsidies
New York Attorney General Eric Schneiderman says he is joining peers in California and several other states in filing a lawsuit to protect the subsidies. Schneiderman says the lawsuit will argue that the subsidies are codified under the ACA, and therefore, they must be paid as long as the health care law remains in force. Eliminating the subsidies is "breathtakingly reckless," he said. "This move is unacceptable, it's cruel, and it is unlawful." (Kodjak, 10/14)

The Associated Press: Many States, Consumers Alarmed By Trump's Health Care Order
President Donald Trump's decision to end a provision of the Affordable Care Act that lowered out-of-pocket medical costs brought swift reaction Friday from the states, as health officials and consumers said they feared the action could chase millions of Americans away from coverage. Attorneys general in nearly 20 states filed a lawsuit against the Trump administration to keep the money flowing, contending that the president is not following a legal requirement to pay the subsidies. (10/13)

The Washington Post: Timing Of White House Actions Unrolling Parts Of ACA ‘Couldn’t Be Worse,’ States Say
After threatening for months to end billions of dollars in payments promised to health insurers, President Trump finally dropped the ax with timing that could inflict maximal disruption on the Affordable Care Act enrollment season scheduled to begin in two weeks. The most immediate upheaval is playing out in a set of states where regulators had ignored the risk that the president might carry out his threat and told insurers not to include any cushion in their 2018 rates for ACA health plans. Officials in at least three states are now debating whether to delay the Nov. 1 start of enrollment as they rush to consider higher premiums to make up for the abrupt loss of federal money. (Goldstein, 10/14)

The Associated Press: Pro-Trump States Most Affected By His Health Care Decision
Nearly 70 percent of those benefiting from the so-called cost-sharing subsidies live in states Trump won last November, according to an analysis by The Associated Press. The number underscores the political risk for Trump and his party, which could end up owning the blame for increased costs and chaos in the insurance marketplace. The subsidies are paid to insurers by the federal government to help lower consumers' deductibles and co-pays. People who benefit will continue receiving the discounts because insurers are obligated by law to provide them. But to make up for the lost federal funding, health insurers will have to raise premiums substantially, potentially putting coverage out of reach for many consumers. (10/14)

The Hill: States That Voted For Trump Most Impacted By ObamaCare Move: Report 
States that voted for President Trump in the 2016 presidential election will be most impacted by his decision to cut off key ObamaCare payments, according to an analysis conducted by The Associated Press. The study found that 70 percent of those who benefit from the subsidies are from states where Trump won. (Savransky, 10/15)

Los Angeles Times: Trump Healthcare Move Threatens Sharply Higher Premiums And Market Chaos
Caught in the middle are millions of Americans likely to see their insurance premiums shoot higher as the administration intensifies its effort to dismantle the 2010 healthcare law, often called Obamacare. Insurers have said that markets in some parts of the country could collapse, leaving many consumers who don’t get insurance on the job with no choices for health plans. And state insurance regulators predicted premiums in the individual market nationally would rise by 12% to 15% next year because of the cutoff. (Levey and Lauter, 10/13)

NPR: Health Insurance Premiums To Rise After Subsidies Stop
The decision will most directly affect middle-class families who buy their own insurance without financial help from the government. Consumers who earn more than 400 percent of the federal poverty level — an individual with income of about $48,000 or a family of four that makes more than $98,400 — will likely see their costs for coverage rise next year by an average of about 20 percent nationwide. People with lower incomes will be unaffected since the ACA, also known as Obamacare, provides government subsidies — in the form of tax credits — that ensure their out-of-pocket insurance costs remain stable. So when premiums rise, those tax credits rise in tandem. (Kodjak, 10/13)

The Wall Street Journal: Major Health Insurers Anticipated End Of Subsidies
Several major insurers said they intend to provide health plans on the Affordable Care Act’s exchanges for the rest of this year and for 2018, despite a financial blow from President Donald Trump’s cancellation of federal cost-sharing payments. The payments, which had been expected to total $7 billion this year, will be “discontinued immediately” because their continuation violates federal law, the Department of Health and Human Services said Thursday. Payments due to go out on Wednesday will be canceled, the administration said in a legal filing. (Wilde Mathews, 10/13)

The Hill: Trump: I'm 'Very Proud Of My Executive Order' On Health Care
President Trump tweeted Saturday he is "very proud" of his recently-signed executive order on health care. “Very proud of my Executive Order which will allow greatly expanded access and far lower costs for HealthCare,” Trump tweeted. “Millions of people benefit!” Trump also claimed that health insurance stocks fell after his decision to end key ObamaCare payments was announced. (Carter, 10/14)

The New York Times: Trump Tweets Approval After Health Care Stocks ‘Plunged’
It is unlike President Trump to cheer when stocks fall, but early on Saturday he did just that. “Health insurance stocks, which have gone through the roof during the ObamaCare years, plunged yesterday after I ended their Dems windfall!” he tweeted. (Fortin, 10/14)

The Hill: Trump Gambles With ObamaCare Moves  
Frustrated by Congress’s inaction on ObamaCare repeal, President Trump is taking a big political risk in using his authority to dismantle the health-care law piece by piece. Democrats say Trump now owns ObamaCare, bearing responsibility for any problems that arise in the system, including higher premiums and insurer exits. (Hellmann and Roubein, 10/15)

The Associated Press: Key Questions And Answers About Trump's Health Care Move
President Donald Trump's move to stop paying a major "Obamacare" subsidy will raise costs for many consumers who buy their own health insurance, and make an already complicated system more challenging for just about everybody. Experts say the consequences will vary depending on how much money you earn, the state you live in, and other factors. (10/14)

Politico: Trump Scraps Obamacare Payments. What Happens Now?
President Donald Trump’s decision to eliminate a key Obamacare insurance subsidy amounted to one of his fiercest attacks yet on his predecessor’s health care law. But it could still be weeks or even months before it’s clear whether the move will be the decisive blow that brings down Obamacare’s insurance marketplaces. (Millman, 10/13)

The Washington Post: Trump Scrapped A Key Obamacare Payment. Here’s What Comes Next.
The decision triggered sharp condemnations from major players across the American health-care system. But while the payments to insurance companies do benefit lower-income Americans, taking these payments away will have some counterintuitive effects — and likely won't hurt the poorest the most. Here's how the effects could play out. (Johnson, 10/13)

The Hill: Five Things To Know About Trump’s Controversial ObamaCare Decision 
The Trump administration’s decision to end payments to insurers meant to help low-income people afford their insurance has set off a battle in the courts and new fears about the possible collapse of former President Obama’s health-care law. Ending the payments is the most dramatic step taken to date by President Trump, who has been frustrated with the GOP Congress’s inability to repeal the law. (Weixel, 10/14)

The Wall Street Journal: Veterans Affairs Head Interviews For Health And Human Services Post
David Shulkin, the current U.S. Secretary of Veterans Affairs and a holdover from the Obama administration, has been interviewed by the White House for the top job at Health and Human Services, according to sources familiar with the meetings. He is one of a number of leading contenders for the position, which has been vacant since late September when former HHS Secretary Tom Price resigned over criticism of his use of private and military planes. (Armour, Kesling and Nicholas, 10/13)

The Washington Post: The Opioid Epidemic: How Congress And Drug Company Lobbyists Worked To Neutralize The DEA
In April 2016, at the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the Drug Enforcement Administration of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets. By then, the opioid war had claimed 200,000 lives, more than three times the number of U.S. military deaths in the Vietnam War. Overdose deaths continue to rise. There is no end in sight. (Higham and Bernstein, 10/15)

The Washington Post: Who Is Joe Rannazzisi: The DEA Man Who Fought The Drug Companies And Lost
Joe Rannazzisi is a man of strong passions who admits that he has a temper. For more than a decade, he was the frontman in the government’s war against opioid abuse. As head of the Office of Diversion Control for the Drug Enforcement Administration, he was responsible for cracking down on doctors, pharmacies, drug manufacturers and distributors who did not follow the nation’s prescription drug laws. He said he worked hard to uphold the law, until he was pushed out by members of Congress and an industry campaign that he says has resulted in a weakening of the nation’s drug laws at a time of unprecedented crisis. (Higham and Bernstein, 10/15)

The Washington Post: Rep. Tom Marino: Drug Czar Nominee And The Opioid Industry’s Advocate In Congress
Tom Marino is a four-term Republican member of the House who represents a district in northeastern Pennsylvania that has been hard-hit by the opioid crisis. Yet Marino also has been a friend on Capitol Hill of the giant drug companies that distribute the pain pills that have wreaked so much devastation around the nation. Marino was the chief advocate of the Ensuring Patient Access and Effective Drug Enforcement Act, which requires the government to meet a higher bar before taking certain enforcement actions. (Higham and Bernstein, 10/15)

The New York Times: A Gun To His Head As A Child. In Prison As An Adult.
Rob Sullivan still remembers the gun and the sound of his mother’s high-pitched pleas. Two thieves had burst into his parents’ Hartford home. Demanding his father’s dope stash, one of the men placed a gun to Rob’s right temple. “Just give it to them,” his mother begged his father. He was 6 years old. (Burch, 10/15)

The New York Times: In Early Results, Shorter Treatment For Tuberculosis Proves Effective
Taking the right antibiotics for just nine months may be as effective against drug-resistant tuberculosis as taking them for two years, as is currently recommended, according to preliminary findings from an international study. Results from the trial, which is overseen by the International Union Against Tuberculosis and Lung Disease and UCL (formerly the University College London), were released at a conference in Mexico. (McNeil, 10/13)

The Washington Post: Is Egg Freezing Safe For Me And My Future Baby?
If you work at such places as Google, Facebook and Apple, your health insurance includes an unusual feature: coverage for egg freezing. Oocyte preservation, touted as a form of fertility insurance for women who want to delay childbearing, has grown in popularity since its “experimental” label was removed in 2012. But as it moves into the mainstream, is it really producing healthy kids? (Blakemore, 10/15)

The New York Times: How Do People Die From Diabetes?
People who have diabetes cannot regulate their blood sugar levels and if the disease isn’t tightly controlled, blood sugar can spike to abnormally high levels, a condition called hyperglycemia, or dip below normal, a condition called hypoglycemia. Both conditions are potentially life-threatening and can lead to coma and death if not promptly treated. But complications resulting from the disease are a more common cause of death. (Rabin, 10/13)

Los Angeles Times: How Guilt, Anxiety And Distress May Help Fight Cancer
Having cancer would make anyone scared, stressed and angry. In some cases, that might be a good thing. Recent research suggests that negative emotions may improve the health of cancer survivors by motivating them to behave in healthier ways. "Negative emotions get a bad rap," says Andree Castonguay, who studies the psychological factors that influence health and make people want to be physically active. "If they're used in the right way, by helping someone set a new goal, they can act as a driving force." (Brown, 10/13)

The Washington Post: Breastfeeding Your Child May Reduce Your Risk Of Breast Cancer
For babies, the benefits of breast-feeding are clear: a stronger immune system, reduced risk for some chronic health conditions and a closer bond with mom. But does breast-feeding also protect women against breast cancer? Nursing has been linked to a reduced risk of breast cancer risk in both pre- and post-menopausal women. But, says Virginia Borges, director of the University of Colorado Cancer Center’s young women’s breast cancer program, “it gets complicated from here.” (Blakemore, 10/15)

NPR: Floating Away Your Anxiety And Stress
When I mentioned to a friend that my baseline neurosis has evolved from daily stress into anxiety, her response was – "Go for a float!" A float? Yes — spend an hour in a dark, soundproof room floating in a body-temperature warm pool. "The heavy salt concentration does the work for you," my friend told me. "You just lie there and meditate." (Schumann, 10/16)

NPR: Mindfulness Apps Turn Device Obsession Inside Out
From fires and hurricanes, to confrontational politics — with all that's been going on, it's no wonder the American Psychological Association found an increase in Americans' stress levels over the last year. Our constant checking of smartphones — with the bombardment of news and social media — can amp up our anxiety. So, why not use your device to help you disconnect? (Aubrey, 10/16)

The New York Times: New York State To Release $360 Million Withheld From City’s Hospitals
After threats of a lawsuit and accusations of bad faith, the administration of Gov. Andrew M. Cuomo announced late Friday afternoon that it would release some $360 million it had withheld from the city’s public hospital system. The money was a large portion of the $380 million that NYC Health & Hospitals said it was owed in federal aid to help cover the costs of caring for uninsured patients and those on Medicaid. (McKinley, 10/13)

The Associated Press: Appeals Court Keeps Arkansas Abortion Pill Limits On Hold
A federal appeals court on Friday prevented Arkansas from enforcing restrictions on how the abortion pill is administered while Planned Parenthood asks the nation's highest court to review a ruling in favor of the law. A three-judge panel of the 8th U.S. Circuit Court of Appeals granted a request by Planned Parenthood Great Plains to not allow an earlier ruling in favor of the restrictions to take effect yet. (10/13)

The Wall Street Journal: New York HIV Nonprofits Expand Services To Other Health Issues
Organizations working with AIDS and HIV patients are a well-established presence in New York City. But as infection rates have dropped and improved medicines have enabled people with the virus to live longer, some groups are adapting their service models and expanding their reach, taking on new health issues from heart disease to heroin addiction. Until recently, Manhattan-based nonprofit Alliance for Positive Change was known as the AIDS Service Center NYC, with a mission to provide New Yorkers with HIV prevention, treatment and support services. (West, 10/15)

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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