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KHN First Edition: Sept. 4, 2015


First Edition

Friday, September 04, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: HHS Unveils Civil Rights Protections For Transgender Patients’ Health Services
KHN staff writer Julie Appleby reports: "The Obama administration issued a sweeping proposal Thursday to bolster civil rights protections in health care, barring medical providers and insurers from discriminating based on gender, whether in treatments or access to facilities or services. The long-awaited rules from the Office of Civil Rights in the Department of Health and Human Services further define protections included in the Affordable Care Act, particularly broadening those for transgender Americans. The proposal also includes provisions requiring medical providers to bolster their communication efforts for people with disabilities or limited English proficiency." (9/4)

Kaiser Health News: Health Care Spending In Massachusetts Rises Faster Than State’s Goal
WBUR's Martha Bebinger, working in partnership with Kaiser Health News and NPR, reports: "For years, Massachusetts has been out in front of other states, trying ideas to change the health system. It passed a state law extending health insurance coverage to almost all citizens four years ahead of the federal health law, and then the commonwealth tried to tackle rising health costs. But the latest numbers are disappointing: Massachusetts spent $632 million more on health care last year than it aimed to, according to a report from the state’s Center for Health Information and Analysis." (9/4)

Kaiser Health News: Consumers With COBRA Coverage Should Weigh Moving To Health Law Plans
KHN consumer columnist Michelle Andrews writes: "As the open enrollment season for employer-sponsored health insurance gets underway this fall, experts say there’s one group that should definitely consider changing plans: people who have coverage through their former employer under the federal law known as COBRA. ... Before the health law passed, people who lost their jobs may not have had other options. Plans on the individual market could turn people down because of their health, and the coverage was often skimpy and expensive in any case. Times have changed." (9/4)

The New York Times: Health Care Rules Proposed To Shield Transgender Patients From Bias
The Obama administration proposed a rule Thursday that would forbid most health insurers and medical providers to discriminate against transgender patients, including by prohibiting insurers from categorically denying coverage of care related to gender transition. The proposal clarifies a civil rights provision of the Affordable Care Act that bans “any health program or activity” that receives federal funds from discriminating based on race, national origin, sex, age or disability. The proposed regulation expands on that broad language, specifying that the administration considers discrimination on the basis of gender identity a form of sex discrimination. (Goodnough and Sanger-Katz, 9/4)

The Washington Post: U.S. Moves To Protect Women, Transgender People In Health Care
The ACA already bars discrimination based on sex and other factors, but the long-delayed proposed regulation issued Thursday explains how the protections will be applied to insurers and health-care providers, such as hospitals and doctors who receive Medicare and Medicaid payments, and it clarifies the standards federal officials would use in implementing the law. The proposed regulation comes as social attitudes about sexuality and gender are undergoing major shifts. (Sun and Bernstein, 9/3)

The Wall Street Journal: Obama Administration Proposes Antidiscrimination Rules Under Health Law
Federal officials have been wrestling for years about how to handle the Affordable Care Act’s provision that requires health insurers and providers to ensure they treat patients equally, including on the basis of their sex and race. The requirement has been in effect since 2010, the year the law was passed, but the administration is still fleshing out its details. The thorniest issue has been whether federal officials also can use the provision to bar bias based on sexual orientation. (Radnofsky, 9/3)

The Associated Press: Plan Targets Health Care Bias Against Transgender People
Mirroring a shift in society, the Obama administration proposed Thursday to ban discrimination against transgender people throughout the health care system. Once the proposed regulations are final, they should expand insurance coverage for gender transition and prohibit health care facilities from denying transgender people access to restrooms that match their individual gender identity. (Alonso-Zaldivar, 9/3)

Reuters: U.S. Government To Extend Healthcare Nondiscrimination Law To Transgender People
The Affordable Care Act, also known as Obamacare, was passed in 2010 and included anti-discrimination provisions to prevent insurers from charging customers more or denying coverage based on age or sex. That law left some areas open to interpretation and thousands of consumers complain each year about being discriminated against, the U.S. Department of Health and Human Services said on Thursday. (9/3)

The Wall Street Journal: Highmark Is Latest To Trim Offerings Under Health Law
Highmark Health said it would reduce its range of offerings on the Affordable Care Act marketplaces, becoming the latest insurer to retrench amid steep financial losses. The big Pittsburgh-based nonprofit company said it would continue to sell plans related to the federal health overhaul in all of the areas it currently serves, which span Pennsylvania, Delaware and West Virginia. But “we will have less products in the market overall,” said David L. Holmberg, the company’s chief executive, who said Highmark had lost $318 million on its individual health-law plans in the first six months of 2015, after rolling out a very broad array of options that had attracted many consumers with chronic conditions who required costly care. (Wilde Mathews, 9/3)

The Wall Street Journal: Lawmakers Seek Extension To 9/11 Health-Care Act
At Thursday’s news conference, U.S. Reps. Carolyn Maloney and Jerrold Nadler, both New York City Democrats, and King, a Long Island Republican, called on their colleagues to make the Zadroga Act permanent. The legislation, signed into law in 2011 after extensive lobbying by survivors, provides for the monitoring and treatment of people suffering from illness and injuries caused by the terrorist attacks. Many 9/11 first responders developed ailments including asthma, lung disease and cancer. (MacMillan, 9/3)

The Washington Post: House Democrats: Congress Should Investigate Anti-Planned Parenthood Activists, Too
Two high-ranking House Democrats are calling on their Republican counterparts to end their congressional investigations of Planned Parenthood -- or at least expand them to encompass alleged misdeed by antiabortion activists who put the group's fetal tissue practices in the spotlight. Rep. John Conyers (Mich.), top Democrat on the House Judiciary Committee, and Rep. Elijah Cummings (Md.), top Democrat on the House Oversight and Government Reform Committee, said in a letter to the Republican chairmen of those committees that the undercover videos that sparked the investigations are unreliable and may have been obtained by illegal means, calling on them to "halt these one-sided investigations immediately." (DeBonis, 9/3)

NPR: Colorado's Long-Lasting Birth Control Program For Teens May Not Last Long
Six years ago, Children's Hospital outside Denver and dozens of clinics around the state began focusing on long-acting forms of contraception, such as IUDs and hormonal implants. Research shows they're much more reliable at preventing pregnancy than the pill or condoms. Liz Romer, who runs the clinic at Children's, where teenagers and young women can get free and confidential birth control, said that's in part because they're less subject to human error. (Horsley, 9/3)

The Washington Post's Wonkblog: The First In A New Generation Of Cheaper Drugs Isn’t Much Cheaper
The first in a long-awaited category of drugs that have been projected to save tens of billions of dollars over the next decade became available today. But its price tag highlights a question economists and industry watchers have been wrestling with for the past few months: how much will these new drugs actually bring down prices? The new drug, Zarxio, is the first American "biosimilar" -- a copycat version of a complex biologic drug. (Johnson, 9/3)

The Wall Street Journal: Big Pharma: The Moment of Dread Is Here
The initial stakes are low for the imminent launch of the first U.S. biosimilar drug. Pharmaceutical companies that develop branded drugs shouldn’t expect them to stay that way. ... Beyond Zarxio’s launch, the stakes will get higher as discounts get larger. Likewise, competition will intensify. In aggregate, drugs with biosimilar competition on the way—such as AbbVie’s Humira or Johnson & Johnson’s Remicade—totaled more than $25 billion in U.S. sales in 2014. (Grant, 9/3)

Los Angeles Times: How To Avoid Becoming A Victim Of Medicare Fraud
Medicare fraud in all its forms is rampant. Though exact numbers aren't known, the government estimates that $60 billion to $90 billion is lost each year to Medicare fraud and abuse. In California, as many as 20% of fraud allegations investigated each year by the Senior Medicare Patrol involve durable medical equipment. Experts offer these tips to avoid becoming a victim of Medicare fraud. (Zamosky, 9/4)

NPR: Legionnaires' Outbreak Contained At Calif. Prison; New Cases In Illinois
The number of confirmed cases of Legionnaires' disease at California's San Quentin prison is holding steady at six, one of three outbreaks of Legionnaires' around the country that have sickened dozens and killed 20. Another 95 San Quentin inmates are under observation because of respiratory illness, state officials said, but they have not been diagnosed with Legionnaires' disease. The inmates are being treated at San Quentin's medical unit. (Aliferis, 9/3)

The Associated Press: Arizona Corrections: 220 Inmates Ill At Prison’s 2 Units
Hundreds of inmates at a state prison in northern Arizona have gotten ill in the past 48 hours, and the state Department of Corrections says it’s working with health officials to identify the cause. The department says lab samples are being sent out to determine why 220 inmates in the Winslow prison complex’s Kaibab and Coronado units have had gastrointestinal illness. (9/3)

The Associated Press: Puerto Rican Voters Prized By Democrats, Republicans
[Marco] Rubio is coming Friday for a fundraiser in San Juan and a rally in Santurce. [Hillary] Clinton plans an event the same day in San Juan about reversing what her campaign calls the U.S. territory’s economic decline and its health care crisis. ... The parade of presidential hopefuls to the territory speaks to the growing power of Puerto Rican voters on the mainland, especially in Florida, the top destination for those fleeing the island’s 12 percent unemployment rate and nine-year economic slump. (Bustos, 9/4)

USA Today: Hillary Clinton To Take Women's Issues Out Of Silo
Hillary Clinton plans to launch a new initiative this weekend as she seeks to weave women’s issues into every facet of her campaign instead of using them in a separate silo as she did in her unsuccessful 2008 presidential bid. ... Unlike previous presidential campaigns, officials say, Clinton will take women’s issues out of their own silo. For instance, Clinton will make expanding paid leave for new mothers part of her economic platform by emphasizing its cost to families. (Przybyla, 9/4)

NPR: Ben Carson, The Other Republican Outsider On The Rise
Donald Trump isn't the only political outsider who's been having a good summer. Retired neurosurgeon Ben Carson is gaining in several polls — especially in the first-in-the-nation caucus state of Iowa, where evangelical voters play a big role. ... On the stump, Carson often talks about his belief in God and his opposition to abortion. He has compared it to slavery and accused Planned Parenthood of targeting African-Americans. (McCammon, 9/3)

USA Today: Biden Says He'll Run If He Has The 'Emotional Energy'
Vice President Joe Biden said Thursday that the biggest factor in his decision on whether to run for president is whether he and his family “have the emotional energy to run.” “The honest-to-God answer is, I just don’t know,” he said. That deeply conflicted response was the first public articulation of a thought process he’s discussed until now only privately with top Democrats and close advisers. He gave no timetable for a decision. (Korte, 94/)

The Wall Street Journal: Hayman Capital’s Kyle Bass Vows To Continue Drug-Patent Challenges
Hedge-fund manager Kyle Bass says he’ll persist in his campaign to invalidate what he calls weak pharmaceutical patents, despite being handed two early setbacks in recent weeks. ... On Wednesday, a panel of judges employed by the U.S. Patent and Trademark Office declined to review Mr. Bass’s challenge to Biogen Inc.’s multiple sclerosis pill Tecfidera patent. The ruling, which came ahead of schedule, followed a denial in August of Mr. Bass’s challenges to Acorda Therapeutics Inc.’s drug Ampyra. (Walker, 9/3)

The Associated Press: Molina To Spend $200 Million On Behavioral, Mental Health Services
Insurer Molina Healthcare will spend about $200 million to expand the behavioral and mental health services it provides with its coverage. The Long Beach-based insurer said Thursday it will buy two subsidiaries of the Providence Service Corp. They are Providence Human Services and Providence Community Services. Molina said the subsidiaries will complement its health plans. (9/3)

The Washington Post: One In Five Kids With ADHD Diagnosed By Doctors Improperly
All sorts of theories have been proposed to explain the alarming rise -- 6.4 million in 2011, a 42 percent jump from 2004 -- in schoolchildren being diagnosed with Attention-Deficit/Hyperactivity Disorder, or ADHD, requiring therapy, medicine or both to make it through their day. ... Now a new report from the Centers for Disease Control and Prevention brings up another possibility: improper diagnosis. (Cha, 9/3)

The Washington Post: More Evidence That The Key To Allergy-Free Kids Is Giving Them Plenty Of Dirt — And Cows
People who grow up on farms -- especially dairy farms -- have way fewer allergy and asthma problems than the rest of us. Now one research team thinks they've brought science closer to understanding why. In a study published Thursday in Science, researchers report that they were able to pinpoint one possible mechanism for the allergy protection in mice they studied. Surprisingly, the protein that they fingered as the likely allergy-preventer doesn't actually affect the immune system -- it affects the structural cells that make up the lining of the lung. (Feltman, 9/3)

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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