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KHN First Edition: October 19, 2015


First Edition

Monday, October 19, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: No Ready-Made Rx For Rising Drug Costs
Kaiser Health News staff writer Julie Appleby reports: "When Turing Pharmaceuticals raised the price of an older generic drug by more than 5,000 percent last month, the move sparked a public outcry. How, critics wondered, could a firm charge $13.50 a pill for a treatment for a parasitic infection one day and $750 the next? The criticism led Turing’s unapologetic CEO to say he’d pare back the increase – although no new price has yet been named – and the New York attorney general has launched an antitrust investigation. The outcry has again focused attention on how drug prices are set in the United States. Aside from some limited government control in the veterans health care system and Medicaid, prices are generally shaped by what the market will bear." (Appleby, 10/19)

Kaiser Health News: Nursing Homes’ Residents Face Health Risks From Antibiotics’ Misuse
Kaiser Health News staff writer Llsa Gillespie reports: "Antibiotics are prescribed incorrectly to ailing nursing home residents up to 75 percent of the time, the nation’s public health watchdog says. The reasons vary — wrong drug, wrong dose, wrong duration or just unnecessarily – but the consequences are scary, warns the Centers for Disease Control and Prevention. Overused antibiotics over time lose their effectiveness against the infections they were designed to treat. Some already have. And some antibiotics actually cause life-threatening illnesses on their own." (Gillespie, 10/19)

The New York Times: Careful Calculus Guides Obama Administration In Health Insurance Projections
[I]t was surprising this week when Sylvia Mathews Burwell, the secretary of health and human services, predicted only slim gains [in health law marketplace enrollment] in the coming year, millions below earlier projections. ... Why did the Obama administration set such a modest goal? It was part of an elaborate numbers game played for several years by proponents and opponents of the health law. On the one hand, administration officials want to manage expectations in a presidential election year, when surpassing the goal will be better for Democrats than falling short. ... On the other hand, health policy experts said, the enrollment goal for 2016 may be realistic. (Pear, 10/16)

The Associated Press: Bigger Bite For Health Law Penalty On Uninsured
The math is harsh: The federal penalty for having no health insurance is set to jump to $695, and the Obama administration is being urged to highlight that cold fact to help drive its new pitch for health law sign-ups. That means the 2016 sign-up season starting Nov. 1 could see penalties become a bigger focus to motivate millions of people who have remained eligible for coverage, but uninsured. They’re said to be more skeptical about the value of health insurance. (Alonso-Zaldivar, 10/19)

The Wall Street Journal: More Health Co-Ops Face Collapse
Health cooperatives are collapsing at such a rapid clip that some co-ops and small insurers are forming a coalition to consider legal action to try to change health-law provisions they blame for their financial distress. Colorado’s co-op and one in Oregon announced Friday that they were folding, joining six others that have already collapsed or said they will unwind operations. The eight co-ops have received nearly $900 million in federal funds that may not be paid back. (Armour, 10/16)

The Washington Post: Two More Obamacare Health Insurance Plans Collapse
Nearly a third of the innovative health insurance plans created under the Affordable Care Act will be out of business at the end of 2015, following announcements Friday that plans in Oregon and Colorado are folding. In just the past week, four co-ops, as the nonprofit plans are known, have decided or been ordered to shut down. Their demise means that eight of the 23 co-ops in existence a year ago will be unavailable to consumers shopping for 2016 coverage through insurance marketplaces created under the ACA. (Levine and Goldstein, 10/16)

The Washington Post: At The Supreme Court, ‘Little Sisters Of The Poor’ Has A Ring To It
If you are looking for sympathetic plaintiffs to headline a major Supreme Court battle — well, it never hurts to have on deck an order of nuns called the Little Sisters of the Poor. That seems especially true when the subject is the Affordable Care Act’s contraceptive requirement. Out of an avalanche of litigation, those urging the court to take up the latest challenge to Obamacare have rallied around the petition filed by the Little Sisters of the Poor Home for the Aged. (Barnes, 10/18)

The Associated Press: Kentucky Election Puts Medicaid Expansion In Crosshairs
Kentucky, one of the only Southern states to expand Medicaid under President Barack Obama's Affordable Care Act, could become the first state to repeal that expansion depending on the outcome of a closely contested governor's race. ... Republican nominee for governor Matt Bevin, along with the legislative leaders of his party, say the state cannot continue to pay for the health insurance of able-bodied adults. Taxpayers pay for health insurance for a quarter of Kentucky's population under the current expansion, which Bevin wants to repeal and replace with a different plan. ... Yet Kentucky's uninsured rate has dropped from a high of 20.4 percent in 2013 to less than 10 percent last year. Hospitals covered less than $60 million of uncompensated care last year, down from $160 million in 2013. New Medicaid enrollees received more than 54,000 preventative screenings, including for breast and colorectal cancer, of which Kentucky has some of the highest rates in the nation. (Bevan, 10/16)

Politico: Budget Talks Stall Before They Even Begin
Congressional Republicans are trying to project confidence, particularly Senate Majority Leader Mitch McConnell, whose “no shutdown, no debt default” vows are paramount to his party’s hopes of maintaining Senate control in 2016. But the Senate GOP has a major uphill battle: McConnell lacks a stable negotiating partner in the House and conservative forces in both chambers already are agitated about making sacrifices in any bipartisan compromise. But Democrats have flatly refused to entertain changes to Social Security or Medicare — a key demand for many congressional Republicans. (Everett, 10/19)

The Washington Post: Advocates, Lawmakers See Momentum For Mental-Health Reform In Congress
Months of deadly mass shootings are pushing mental-health legislation forward in Congress, with advocates and lawmakers describing a momentum for change that they haven’t seen for nearly a decade. Early this month, by sheer coincidence, leaders of five advocacy groups met with the head of a powerful House committee just hours after a student opened fire at an Oregon community college. As pictures of the campus flashed on the TV screen in his office, Energy and Commerce Committee Chairman Fred Upton (R.-Mich.) promised to make mental-health reform a priority this fall. (Sun, 10/18)

The Associated Press: Clinton Wants Congress To Fix Spike In Medicare Bills
Hillary Rodham Clinton is urging Congress to fix an "outrageous and senseless" expected increase in Medicare deductibles and premiums. Clinton says she is "deeply concerned" by news that there will be no cost-of-living increase in Social Security benefits next year. As a result, some Medicare bills are set to increase for many, unless Congress acts to prevent it. (Thomas, 10/16)

The New York Times: Hillary Clinton Puts Republicans On Spot On Looming Entitlement Threat
And she is pressing the Republican presidential candidates to speak out on the matter. “I am deeply concerned by how this could harm Medicare beneficiaries,” Mrs. Clinton said in a statement. “This is outrageous and senseless, and Congress must act to fix the law. I support efforts by the Obama administration and Democratic leaders in Congress to try to resolve this quickly. At a time when out-of-pocket medical costs are already rising, we cannot afford to let Republican obstructionism pile additional costs on our seniors. I urge the Republican candidates for president to call on their congressional majority to end the games and protect our seniors.” The statement from Mrs. Clinton came as the Obama administration is urging Congress to adjust the increase in health insurance premium increases, which could affect almost a third of Medicare beneficiaries. Discussions taking place among leaders in Congress to resolve the problem, but there is a concern that House Republicans may not be persuaded to address it. (Haberman, 10/16)

The New York Times: Theranos, A Blood Test Start-Up, Faces F.D.A. Scrutiny
Theranos, a closely watched start-up that vowed to revolutionize medical testing, said on Friday that because of questions raised by the Food and Drug Administration, it had temporarily halted its trademark practice of collecting tiny blood samples from finger pricks. The privately held Theranos has reportedly been valued at more than $9 billion, roughly akin to the laboratory giants Quest and LabCorp. That is based on Theranos’s purported ability to perform dozens of medical tests using only drops of blood from a finger, rather than the conventional larger vials collected from the crook of the arm. (Pollack and Abelson, 10/16)

The Wall Street Journal: Hot Startup Theranos Has Struggled With Its Blood-Test Technology
On Theranos Inc.’s website, company founder Elizabeth Holmes holds up a tiny vial to show how the startup’s “breakthrough advancements have made it possible to quickly process the full range of laboratory tests from a few drops of blood.” The company offers more than 240 tests, ranging from cholesterol to cancer. It claims its technology can work with just a finger prick. ... But Theranos has struggled behind the scenes to turn the excitement over its technology into reality. (Carreyrou, 10/16)

The Washington Post's Wonkblog: The Wildly Hyped $9 Billion Blood Test Company That No One Really Understands
A few days ago, the chief executive of one of the hottest and most secretive health care companies was named one of "five visionary tech entrepreneurs who are changing the world" by the New York Times. Elizabeth Holmes, the head of blood testing company Theranos, has also appeared on the cover of Fortune, was the subject of an admiring profile in the New Yorker, and was this month splashed on the cover of Inc. with the understated headline "The Next Steve Jobs." A deeply reported investigative story by the Wall Street Journal on Thursday revealed that despite its $9 billion valuation and its board made up of political heavyweights -- including Henry Kissinger and former secretary of state George Shultz -- Theranos' actual revolutionary technology may be falling flat. (Johnson, 10/16)

The Washington Post: A Comprehensive Guide To Theranos’s Troubles And What It Means For You
A deeply reported story by the Wall Street Journal has pulled the curtain back on Theranos, the hot and intensely secretive Palo Alto, Calif., company that aims to revolutionize how we get our blood tested. The newspaper's investigation raises questions about the accuracy and also the novelty of what the company is doing. Here's a guide to the growing questions about this company, the industry, and why it matters. (Johnson and Cha, 10/17)

Los Angeles Times: High-Flying Kite Could Score Big With New Cancer Treatment
Kite Pharma, one of the hottest biotech start-ups on Wall Street, hopes to revolutionize the treatment of a common, deadly lymphatic cancer — with a novel mix of highly trained lab techs and high-speed air travel. The Santa Monica company's treatment of non-Hodgkin's lymphoma reprograms a patient's T-cells — the kind that are supposed to fight disease — to seek and destroy only abnormal, cancerous lymph cells, not the healthy ones crucial for human life. But in order to do so, blood must be drawn from a patient, refrigerated and flown to Kite's headquarters, where the cells are modified, frozen and then flown back to doctors who re-inject them into patients. (Pfiefer, 10/17)

Los Angeles Times: Insurance Start-Up Oscar Seeks To Shake Up Healthcare Through Its App
Welcome to Oscar Insurance Corp., a Silicon Valley-backed start-up promising big changes to the cumbersome healthcare industry through its sleek mobile app. The New York-based insurer, a new player in the Southern California market, plans to offer insurance next month in the individual market on the Covered California exchange, where the four largest companies control 94% of the individual market. (Khouri, 10/18)

USA Today: It Takes A Village - And Lots Of Money - To Care For A Parent With Dementia
Sandy Markwood, CEO of the National Association of Area Agencies on Aging, advises families to start thinking about how to get and pay for 24-hour care as soon as a loved one is diagnosed with dementia. That way, parents can have a say in their care when they are lucid enough to do so, and family members can know the patient’s wishes. They can also start thinking about ways to arrange caregiving among siblings, find the supportive services they need, adapt the parent’s home, and ensure that there is safe transportation to and from doctor’s appointments. (O'Donnell and Ungar, 10/17)

The New York Times: Veterans Affairs Official Overseeing Backlog Of Claims Resigns
The Department of Veterans Affairs administrator in charge of reducing the huge backlog of veterans benefits, who was a frequent target of critics, resigned on Friday despite a vast reduction in pending claims. The administrator, Allison A. Hickey, became under secretary for benefits in 2011, overseeing 20,000 employees and benefits for more than 12 million veterans and their families. (Philipps, 10/16)

The Wall Street Journal: Top Veterans Affairs Official Allison Hickey Resigns
A top Department of Veterans Affairs official resigned Friday, weeks after the department’s internal watchdog found irregularities in promotions and reimbursements involving nearly two-dozen senior executives in her department. Allison Hickey, who was Under Secretary for Benefits at the VA, weathered the VA wait-time scandals in the summer of 2014 that led to the resignation of other top officials and then-Secretary Eric Shinseki. Ms. Hickey’s resignation was announced by Secretary Robert McDonald in a statement. No reason was given. (Kesling, 10/16)

Los Angeles Times: Draft Master Plan Is Unveiled For Long-Neglected VA Campus In West L.A.
After months of often rancorous meetings with veterans, Westside residents, health professionals and elected officials, the U.S. Department of Veterans Affairs on Friday released a draft master land-use plan for the agency’s long-neglected West Los Angeles campus. The document satisfies a key requirement of the January settlement of a 2011 lawsuit filed on behalf of chronically homeless veterans. The suit alleged that the VA was illegally leasing land to corporations, schools and other entities while failing to provide adequate care for men and women who had served in the military. (Groves, 10/16)

The Associated Press: Leader Behind Vermont Aid-in-Dying Law Uses It, Ends Life
Richard "Dick" Walters, a leader in the effort to get [Vermont] to pass aid-in-dying legislation, used the rules established under the law to end his own life on Friday. He was 90 years old and had been battling cancer. Walters, the leader of Patient Choices Vermont, died at a Shelburne retirement community where he had been staying, said the Necrason Group, a Montpelier lobbying firm that worked with him. (Gram, 10/16)

The New York Times: A Small Indiana Town Scarred By A Trusted Doctor
Mrs. Davidson is now one of 293 patients around Munster, Ind., who have filed lawsuits against Dr. Gandhi and two other doctors in his practice claiming that they performed needless procedures. The Indiana state Medicaid program has started an investigation .... Lawyers for Dr. Gandhi and his practice, Cardiology Associates of Northwest Indiana, said they had not received any subpoenas, and the doctors denied any wrongdoing. In recent years, federal officials have brought several prominent cases against cardiologists and hospitals, accusing them of performing unnecessary procedures like inserting stents into coronary arteries. While medical professionals say there is no indication that cardiology has more unnecessary procedures than, say, orthopedics, they do note that the specialty has come under increased scrutiny by regulators because the procedures tend to be reimbursed by Medicare and private insurance at significantly higher levels than those in many other specialties. (Creswell, 10/17)

The Associated Press: Patient Numbers Lagging At Virginia Proton Therapy Center
The Hampton University Proton Therapy Institute has treated a fraction of the cancer patients it was expected to serve since it treated its first patient in September 2010. The institute blames several reasons for the lower-than-anticipated number of patients, including increasing competition and decreasing insurance reimbursements, among other factors, The Daily Press reports. (10/18)

The Associated Press: Judge To Rule On Planned Parenthood Funding In Louisiana
A federal judge said he will decide by Monday whether to block Gov. Bobby Jindal’s attempt to cut off state Medicaid funding for Planned Parenthood’s Louisiana clinics. Jindal, a Republican presidential candidate, began the defunding effort after secretly recorded videos were released by an anti-abortion group purportedly showing Planned Parenthood illegally selling fetal tissue for profit. The videos led to similar defunding efforts by Planned Parenthood opponents in other states and in Congress. (McGill, 10/16)

The Associated Press: NYC College Getting $10.7M Grant To Train For Health Jobs
A community college in the Bronx is getting a $10.7 million federal grant to train students for health-care jobs such as certified nurse assistant and patient care technician. Hostos ... Community College announced the five-year grant from the U.S. Department of Health and Human Services on Friday. It is the largest grant in the 47-year history of the college. (10/16)

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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