Incentives advanced by state-based health reforms and the federal health law have created new opportunities for nonprofit organizations like Boom!Health, says Robert Cordero, the integrated clinic’s ougoing president. (Lisa Gillespie, 8/10)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Better Recognize'" by Larry Lambert.
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The legislation, yet to be drafted, will likely include "premium support" for beneficiaries on the program. Elsewhere, Medicare will pay for an expensive cancer treatment and Select Medical's long-term hospitals face the prospect of harm from new payment rules in the program.
National Journal: House GOP Looks Ahead To Huge Medicare Overhaul In 2016
For years, Republicans have openly pined for pushing Medicare further into the private sector. But they have been restrained by the practical realities of divided government and the political risks of a plan that Democrats have said would turn the popular insurance program into a voucher system. Conservatives on Capitol Hill, however, have not surrendered the dream and now are planning to undertake the dirty work to make it a legislative reality. House Republicans will start working next year on drafting a Medicare "premium-support" bill, according to Ways and Means Health Subcommittee Chairman Kevin Brady. It is the most ambitious item on the upcoming legislative agenda that the Texas Republican laid out in an interview with National Journal. (Scott, 8/10)
The New York Times: Medicare, Reversing Itself, Will Pay More For An Expensive New Cancer Drug
The Obama administration has decided that Medicare will pay for one of the newest, most expensive cancer medications, which costs about $178,000 for a standard course of treatment. Patients, doctors, hospital executives and insurers have expressed concern about the high cost of prescription drugs, especially new cancer medicines and treatments tailored to the genetic characteristics of individual patients. Medicare officials recognized the cost and value of one such product, the anticancer drug Blincyto, by agreeing to make additional payments for it starting Oct. 1. The drug is made by Amgen for patients with a particularly aggressive form of leukemia. The decision suggests a new willingness by Medicare to help pay for promising therapies that are still being evaluated. It is also significant because Medicare officials reversed themselves on every major scientific issue involved. (Pear, 8/8)
The Wall Street Journal: Select Medical May See Effects Of New Medicare Rules Before Some Rivals
New Medicare-payment rules for long-term hospitals that will begin to take place later this year are expected to disruptive throughout the industry. But some facilities owned by Select Medical Holdings Corp. will face the changes months before hospitals run by some of its rivals. In a call with investors Friday, Select Chief Executive Robert Ortenzio said the federal Medicare agency had blocked the company’s plan to change many of Select’s hospitals fiscal-reporting years to delay the impact of the changes. (Weaver, 8/7)
And seniors flock to Mexico for cheaper dental care not covered by Medicare -
The Associated Press: Facing Rising Dental Costs, Seniors Head To Mexico
Mark Bolzern traveled 3,700 miles to go to the dentist. The 56-year-old Anchorage, Alaska, native left home this spring, made a pit stop in Las Vegas to pick up a friend, and kept heading south, all the way to Los Algodones, Mexico, a small border town teeming with dental offices. About 60 percent of Americans have dental insurance coverage, the highest it has been in decades. But even so, the nation's older population has been largely left behind. Nearly 70 percent of seniors are not insured, according to a study compiled by Oral Health America. A major reason is because dental care is not covered by Medicare and many employers no longer offer post-retirement health benefits. What's more, the Affordable Care Act allows enrollees to get dental coverage only if they purchase general health coverage first, which many seniors don't need. At the same time, seniors often require the most costly dental work, like crowns, implants and false teeth. (Galvan, 8/8)
Meanwhile, news outlets look ahead to the next phases in the implementation of the health law, including delayed anti-discrimination rules from the administration as well as efforts by health care providers to make sure those who have gained insurance coverage use it to help their health.
The Wall Street Journal: Audit Of Health Exchanges Finds Fault With Controls
Some consumers who got health coverage or subsidies through HealthCare.gov might not have been eligible to receive them last year because of deficiencies in the federal exchange’s internal controls, according to a government report likely to further stoke Republican criticism. (Armour, 8/10)
Politico Pro: No Action On Health Law Anti-Discrimination Regs After Five Years
The Obama administration has yet to spell out how it will enforce a key provision of the Affordable Care Act prohibiting discrimination in health care delivery more than five years after the law’s passage. Patient advocates and regulatory experts are mystified by the lack of action on the civil rights protections. (Demko, 8/7)
The Connecticut Mirror: The Next Big Push: Getting People Health Care, Not Just Insurance
Since the federal health law’s major provisions rolled out last year, much of the attention has been on getting people signed up for private insurance or Medicaid. But increasingly, the focus of those in health care, insurance and advocacy groups is turning to what comes next: making sure those who gained coverage use it to improve their health, and ensuring that the health care system is adapting to meet their needs – things that could be significantly more complicated than getting people signed up for coverage. (Levin Becker, 8/10)
In exchange news, Connecticut is developing a tool to help consumers see the true cost of health plans before making an enrollment decision -
The Connecticut Mirror: In Insurance, Premium Isn’t The Full Price. Can A Tool Help Shoppers?
Many people shopping for health insurance pick plans with the lowest monthly cost. But experts say that’s not necessarily the best buy, since those plans often leave members with steep out-of-pocket costs when they get care. In some cases, advocates and officials say, people who picked the cheapest options – known as bronze plans – ended up not using their coverage because they couldn’t afford to pay for care. (Levin Becker, 8/7)
Last week, the court reversed a decision by a lower court that allowed the organizations to get around this Affordable Care Act requirement.
The Associated Press: Catholic Groups Lose Another Contraceptive Court Ruling
Another federal appeals court Friday ruled against Catholic church-affiliated groups that oppose being required to provide contraceptive care to employees through a third party. The 2nd U.S. Circuit Court of Appeals overturned a Brooklyn judge's ruling affecting over 25,000 employees at two high schools, six hospitals, three nursing homes and several nonprofits. The appeals court in Manhattan said an Affordable Care Act provision that lets religion-related entities put the burden for providing contraceptive care services on third parties does not erode religious rights. (Neumeister, 8/7)
The New York Times: Court Says 4 Catholic Nonprofits Must Allow Workers Access To Contraception
Four Roman Catholic nonprofits in New York must allow employees access to contraception, a federal appeals court panel ruled on Friday, reversing a decision by a lower court that allowed the organizations to get around a requirement in the Affordable Care Act. Six other circuit courts around the country deciding on similar arguments involving religious groups have come to similar conclusions, the unanimous three-judge panel noted in its decision, which was written by Judge Rosemary S. Pooler for the United States Court of Appeals for the Second Circuit, in New York. Other cases are still pending. (Clifford, 8/7)
Republicans on the Energy and Commerce Committee released a letter in which they ask to speak with some of the Planned Parenthood officials who, on a secretly taped video, discuss providing fetal tissue to medical researchers.
Reuters: U.S. Congress Inquiry Into Planned Parenthood Widens
Several Planned Parenthood officials and three private bio-medical firms were targeted on Friday by a U.S. congressional panel as lawmakers dig deeper into a controversy swirling around the women's health organization. A U.S. House of Representatives committee made public a letter requesting interviews with personnel from the organization who appeared in surreptitiously recorded videos in discussions about providing fetal tissue for research. House Energy and Commerce Committee Republicans also said they had written to three companies identified as human fetal tissue suppliers to request information and briefings. (Cornwell, 8/7)
CBS News: Abortion Controversy Overshadows Planned Parenthood Health Services
Republican calls to end federal funding of Planned Parenthood, after an anti-abortion group released a series of undercover videos, have put a spotlight on the organization in recent weeks. ... The organization says the recent controversy has taken attention away from the many health care services it provides to both women and men that are not abortion-related. According to the annual report, 42 percent of the services it provides is for STI/STD testing and treatment, 34 percent is for contraception, and 9 percent goes to cancer screening. Another 12 percent is miscellaneous women's health and other health services. The 327,653 abortions Planned Parenthood clinics perform each year make up just 3 percent of the total services the group provides. (Welch, 8/7)
Among the field of Republican primary candidates, anti-abortion positions are getting a lot of play -- even though they appear to run contrary to public opinion. Meanwhile, Jeb Bush continues to get attention regarding his involvement with a charity that supported Planned Parenthood and comments he made about funding for women's health.
The Washington Post: As Campaign Heats Up, Republican Candidates Are Rushing To The Right
But it could also cause the eventual nominee problems in a general election with a more moderate electorate. On social issues ranging from abortion to same-sex marriage, much of the Republican field has now taken positions that are at odds with mainstream American opinion. For example, 3 out of 4 Americans
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