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KHN First Edition: October 7, 2015


First Edition

Wednesday, October 07, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Express Scripts To Cover Pricey New Cholesterol Drugs
Kaiser Health News staff writer Julie Appleby reports: "The nation’s largest pharmacy benefit manager said Tuesday it’s not going to try to bring down costs by forcing the makers of two pricey new cholesterol drugs to compete against each other, as it successfully did this year with expensive hepatitis C treatments. Instead, Express Scripts said it will control spending by aggressively managing which patients get the injectable medications. The firm also said it won some discounts from the treatments’ estimated $14,000 annual list price." (Appleby, 10/7)

Kaiser Health News: Whistleblower Doctor Warns About Hospitals Hiring Physicians
Kaiser Health News staff writer Jay Hancock reports: "There is a good chance that your once-independent doctor is now employed by a hospital. Dr. Michael Reilly, a Fort Lauderdale, Fla., orthopedic surgeon, does not believe this is good for physicians, patients or society. For years he watched Broward Health, a nonprofit Florida hospital system, hire community doctors, pay them millions and minutely track the revenue they generated from admissions, procedures and tests. ... Last month Broward Health agreed to pay $70 million to settle allegations that it engaged in 'improper financial relationships' with doctors under laws prohibiting kickbacks in return for patient referrals." (Hancock, 10/7)

The Wall Street Journal: Express Scripts To Cover Both New Cholesterol Drugs
The first major showdown between two new effective but expensive cholesterol-lowering drugs resulted in a draw. Express Scripts Holding Co., the big pharmacy-benefits manager, said it would include both drugs—Praluent from Regeneron Inc. and Sanofi SA and Repatha from Amgen Inc., on its national list of covered medicines. ... Insurance coverage for the two agents, known as PCSK9 inhibitors, has been an unanswered question since the drugs were approved this summer. The list price for Praluent is about $14,600 a year while Repatha is priced at $14,000. (Winslow, 10/6)

The New York Times: Express Scripts Says It Will Cover 2 New Cholesterol Drugs
The nation’s largest manager of drug prescriptions said on Tuesday that it would pay for two drugs in a promising new class of cholesterol-lowering medicines, rather than choose one over the other in an effort to lower costs. The pharmacy benefits manager, Express Scripts, and some others had expressed concern about the price of the drugs, Repatha from Amgen and Praluent from Sanofi and Regeneron Pharmaceuticals, both more than $14,000 a year. They said that with millions of Americans needing to further lower their cholesterol, the products, known as PCSK9 inhibitors, could become one of the largest drug categories, straining health care budgets. (Pollack, 10/6)

The Associated Press: Express Scripts To Cover Pricey New Cholesterol Treatments
The nation’s biggest pharmacy benefits manager has decided to cover two new drugs that lower artery-clogging cholesterol but raise concern over prices that can top $14,000 a year. Express Scripts said Tuesday that it will pay for prescriptions of Amgen Inc.’s Repatha as well as Praluent from Sanofi and Regeneron Pharmaceuticals Inc. under a few conditions designed to control costs. (Murphy, 10/6)

Los Angeles Times: Prescription Firm Agrees To Cover Pricey New Cholesterol Drugs -- For Some
The nation's largest pharmacy benefits manager said it would cover two pricey new cholesterol drugs, including one by Amgen Inc., but limit them to patients who need them most. Express Scripts Inc., a St. Louis company that helps employers and health plans manage the costs of prescription drugs, said Tuesday that it had reached a deal to cover Repatha by Amgen and Praluent by Sanofi and Regeneron Pharmaceuticals Inc. at a discount from their suggested retail price. (Pfeifer, 10/6)

The Associated Press: Gov't Health Insurance Website Getting Upgrades
Consumers shopping on the government's health insurance website should find it easier this year to get basic questions answered about their doctors, medications and costs, according to an internal government document. A slide presentation dated Sept. 29 says's window-shopping feature is getting a major upgrade. Window shopping is a popular part of the website that allows consumers to browse for taxpayer-subsidized health insurance plans. (Alonso-Zaldivar, 10/7)

The New York Times: Hillary Clinton’s Health Care Proposals, Focused On Cost, Go Well Beyond Obama’s
Hillary Rodham Clinton, as she offered up a sheaf of new health care proposals, said she was “building on the Affordable Care Act.” But lurking in those proposals was a veiled criticism of President Obama’s signature domestic achievement: For many families, the Affordable Care Act has not made health care affordable. Mr. Obama has spent five years minimizing cost issues still confronting many health care consumers. Mrs. Clinton is taking those on without apologies. She would go beyond the president’s 2010 law, capping a patient’s share of the bill for doctor visits and prescription drugs. She would repeal the law’s planned tax on high-cost employer-sponsored insurance — a tax the White House says is needed to constrain the growth of health spending. (Pear, 10/6)

Los Angeles Times: How The Debate Over Healthcare Is Changing - Just In Time For The 2016 Election
With the first primaries of the 2016 presidential campaign just months away, the national healthcare debate is poised to enter a new phase, more focused on consumers’ pocketbooks than on re-litigating the 5-year-old Affordable Care Act. Hillary Rodham Clinton, who is campaigning on a detailed program to crack down on rising drug prices and runaway medical bills, is making a play for the hearts of voters increasingly irritated about what they have to pay for healthcare. In the process, Clinton, the front-runner for the Democratic presidential nomination, has issued an implicit challenge to her Republican rivals, who continue to campaign with broadsides against Obamacare but few details about how they would address consumers’ basic healthcare worries. (Levey, 10/7)

NPR: Inside The Message Machine That Could Make Politicians More Persuasive
It sounds like a politician's dream: a machine that can tell you exactly what to say to change a voter's mind. Well, that's what a political scientist has come up with — at least, a first tentative step in that direction. Using text from a pro-Obamacare website and testing different combinations of sentences on volunteers, an algorithm created by Northeastern University assistant professor Nick Beauchamp was able to identify optimally persuasive terms that make people more inclined to support the landmark health care law. Sentences including words like "pre-existing," "condition," "coverage" tended to leave study volunteers feeling more positive about the law. "States," "federal" and "government" were among the topics that turned people off Obamacare. (Detrow, 10/6)

The Washington Post: Want To Get Your Partner’s Child Insured? Put A Ring On It, Federal Employees Told.
The Obama administration reversed a policy Monday that had allowed unmarried federal employees and retirees in same-sex domestic partnerships to obtain insurance coverage for children of their partners under certain conditions. The change, applying to the separate insurance programs for health care and for vision and dental care, is a fallout of the June U.S. Supreme Court decision requiring all states to allow and recognize same-sex marriage. It overturns a policy that itself was a result of a ruling by the high court two years earlier and could be a harbinger of other changes in eligibility for federal employee benefits. (Yoder, 10/6)

Los Angeles Times: Referendum Papers Filed On Assisted Suicide Law
A day after Gov. Jerry Brown signed a bill allowing assisted suicides for the terminally ill in California, opponents filed papers to seek a referendum to overturn the measure on the November 2016 ballot. A group called Seniors Against Suicide filed papers with the state attorney general’s office to get an official title and summary for the referendum, the first step toward collecting signatures. The group would have 90 days, or until Jan. 3, to collect the signatures of 365,880 registered voters, a difficult task as those behind a failed referendum on the state’s new vaccine law recently found out. (McGreevy, 10/6)

The Associated Press: Right-To-Die Backers Say California Helps Fight Elsewhere
It will soon be legal for the terminally ill to end their own lives in the nation's most populous state, and right-to-die advocates expect other states to follow California's example. Gov. Jerry Brown signed a bill Monday that allows such physician-assisted deaths, marking a major victory for proponents who spent decades and millions of dollars pushing through such a measure. California marks a turning point, and its legislation includes more safeguards than the other four states where the practice is legal, the law's supporters say. They are now focusing on New Jersey, where the state Senate is slated to debate a similar bill this fall, and Massachusetts, where a legislative hearing on the issue is set for this month. (Watson, 10/6)

The Washington Post: Right-To-Die Advocates Hope To Mimic California Victory In D.C., Maryland
National right-to-die advocates are hoping their recent success in California will boost their efforts to allow terminally ill patients to legally end their lives in Maryland and the District. ... Maryland on Tuesday held a workshop on an assisted-suicide bill introduced by Del. Shane E. Pendergrass (D-Howard) where lawmakers heard from officials in Vermont and Oregon about the implementation of similar laws. Pendergrass started the hearing by reading Brown’s letter in signing California’s law, highlighting that the governor said he would not take options from others facing excruciating death despite his Catholic background. (Nirappil, 10/6)

Politico: Arkansas To U.S. Supreme Court: Overturn Roe V. Wade
Arkansas has asked the Supreme Court to revisit its long-standing ruling that a woman can terminate a pregnancy until the fetus is viable outside of the womb. Arkansas on Tuesday asked the justices to overturn a lower court decision that found that the state’s ban on abortion at 12 weeks of pregnancy and when a heartbeat is detected is unconstitutional. (Haberkorn, 10/6)

The Associated Press: Planned Parenthood Asks Judge To Expand Arkansas Case
Planned Parenthood has asked a federal judge to expand a ruling that temporarily blocked Arkansas from cutting off Medicaid payments for three patients after the state canceled the organization’s contract amid controversy over videos secretly recorded by an anti-abortion group. The organization filed a request late Monday seeking class-action status for its lawsuit challenging Gov. Asa Hutchinson’s termination of its contract, saying the lawsuit should cover current and future Medicaid patients who seek treatment at Planned Parenthood. (Bleed, 10/6)

Reuters: Planned Parenthood Seeks Class Action Status After Arkansas Cuts Payments
Planned Parenthood has sought class action status for its Medicaid patients in Arkansas after a U.S. judge ordered the state to continue payments to three women who challenged Arkansas' move to halt payments to the organization. The filing in federal court in Arkansas on Monday could reverse the state's decision to cut off funding for Planned Parenthood programs in the state, lawyers for the group said on Tuesday. (Barnes, 10/6)

Politico: Judge Rules That Anti-Planned Parenthood Activists Can Give Congress Undercover Videos
Heading off a potential constitutional clash, a federal judge ruled Tuesday that anti-abortion activists can hand over unreleased undercover sting videos and outtakes subpoenaed by a House committee even though a court order remains in place barring those activists from releasing the materials publicly. U.S. District Court Judge William Orrick said Tuesday that he would not prevent activist David Daleiden and the Center for Medical Progress from complying with the subpoena issued last month by House Oversight and Government Affairs Committee Chairman Jason Chaffetz. (Gerstein, 10/6)

The Washington Post's Wonkblog: For Decades, The Government Steered Millions Away From Whole Milk. Was That Wrong?
U.S. dietary guidelines have long recommended that people steer clear of whole milk, and for decades, Americans have obeyed. Whole milk sales shrunk. It was banned from school lunch programs. Purchases of low-fat dairy climbed. ... Whether this massive shift in eating habits has made anyone healthier is an open question among scientists, however. In fact, some recent evidence indicates that just the opposite might be true: millions might have been better off had they stuck with whole milk. Scientists who tallied diet and health records for several thousand patients over ten years found, for example, that contrary to the government advice, people who consumed more milk fat had lower incidence of heart disease. ... This year, as the “Dietary Guidelines for Americans” undergoes one of its periodic updates, the federal bureaucrats writing them must confront what may be the most controversial and weighty question in all of nutrition: does the consumption of so-called saturated fats - the ones characteristic of meat and dairy products - contribute to heart disease? (Whoriskey, 10/6)

The New York Times: Schools Report Varying Results In Their Efforts To Comply With Nutrition Guidelines
As students lined up for lunch at the Washington Technology Magnet School cafeteria [in St. Paul, Minn.] on a recent late morning, taco pizza was available along with the fresh fruits and vegetables. Angie Gaszak, a school system nutritionist, said the school tries to offer a mix. “We want to make sure they eat healthy, but we also want to serve things that they will eat,” Ms. Gaszak said. It is a balance that is hard to achieve as school systems try to comply with legislation signed in 2010 by President Obama that required schools to update their nutritional standards to cut back on sugar and sodium in foods and add more fruit and vegetables for the 30 million children they serve. (Nixon, 10/6)

The Associated Press: Chief Justice Won't Delay Wage Rules For Home Care Workers
Supreme Court Chief Justice John Roberts won't hold up new Obama administration regulations that give overtime and minimum wage protections to nearly 2 million home health care workers. Roberts on Tuesday denied an emergency request from three home care industry trade groups that said the rules set to take effect Oct. 13 threaten irreparable harm to businesses that provide in-home care for the elderly and disabled. (10/6)

NPR: Seniors Tend To Quit Medicare Advantage When Health Declines
Senior citizens are switching from privately run insurance plans to traditional Medicare when they face serious, long-term health conditions, a study shows. Researchers at Brown University found that 17 percent of Medicare Advantage patients who entered nursing homes for long-term care chose to switch to traditional Medicare the following year. Only 3 percent of similar patients in Medicare made the decision to go to a private Medicare Advantage plan. (Kodjak, 10/6)

The Associated Press: Inmates Help Other Prisoners Face Death In Hospice Program
[Scott] Abram is a counselor trained in a national ministry program who sees his volunteer work as part of his own growth. Behind bars since the early 1990s for murder, he has gotten used to spending time with male prison friends as they die in rooms 205 or 206 on the second floor of the state's prison for chronically ill inmates. ... He is one of 15 male and female inmates trained in the program at Franklin Medical Center, a small prison just south of downtown Columbus that houses some of the state's sickest inmates, many of whom die there. (Welsh-Huggins, 10/6)

NPR: Hospitals Still Don't Give Moms Enough Support For Breast-Feeding
Most hospitals around the country aren't doing a good job of helping new moms who want to breast-feed, researchers report Tuesday in the journal Morbidity and Mortality Weekly Report. Several common practices at the institutions may actually prevent moms from sticking with breast-feeding for six months — the duration thought to be most healthful for babies. (Doucleef, 10/6)

The Washington Post: How The FDA Is Trying To Keep ‘Hip-Hop’ Teens From Smoking
Can the federal government do hip-hop? That's the goal of a new ad campaign from the Food and Drug Administration, which aims to embrace the attitude and style of "hip-hop culture" in an effort to dissuade young African Americans, Hispanics and other minority teenagers from smoking. The $128 million "Fresh Empire" campaign, funded by fees on the tobacco industry, will include television ads, local outreach efforts and events featuring DJs and musicians -- all intended to curb smoking among minority teenagers. (Dennis, 10/6)

The Associated Press: FDA'S New Anti-Smoking Campaign Uses Hip-Hop To Target Youth
Government health officials are betting they can adapt the sounds, style and swagger of hip-hop culture to discourage young African Americans, Hispanics and other minority youths from using tobacco. ... FDA officials say research shows young people who identify with hip-hop are more likely to use cigarettes and other tobacco products than their peers. To be sure, hip-hop's origins as an anti-establishment, urban movement seem to clash with the federal government's buttoned-down image. But FDA officials predict they can convincingly pitch their message to hip-hop fans, based on focus group testing. (Perrone, 10/6)

Reuters: Nevada Agrees To Pay San Francisco $400,000 Over Patient Dumping
Nevada has agreed to pay the city of San Francisco $400,000 to settle a lawsuit claiming that the state bused patients, many of them poor and mentally ill, from a Las Vegas hospital to the Bay Area without plans for their care, Governor Brian Sandoval's office said on Tuesday. The settlement, which must still be approved by the San Francisco Board of Supervisors and the Nevada Board of Examiners, includes attorneys' fees and a plan for better management and transfer of patients. (Skinner, 10/6)

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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