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KHN First Edition: October 20, 2015


First Edition

Tuesday, October 20, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid
Kaiser Health News staff writer Anna Gorman reports: "Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid coverage until they turn 26. The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26th birthday. But these young adults are encountering a major barrier: They are only guaranteed coverage in the state where they were in foster care. States have the option of extending the benefit to all former foster youths, but only about a dozen have done so." (Gorman, 10/20)

Kaiser Health News: The North Carolina Experiment: How One State Is Trying To Reshape Medicaid
WFAE's Michael Tomsic, working in partnership with Kaiser Health News and NPR, reports: "North Carolina is in the process of overhauling its Medicaid program. The governor and state lawmakers are using a mixture of health care models to put the major players — doctors, hospitals and insurers — all on the hook to keep rising costs in check. For many of the Republicans who control the state legislature, the reason for the change is simple: budget predictability." (Tomsic, 10/20)

The Associated Press: Potential Delay On Some Upgrades To Gov't Insurance Site
With sign-up season starting in less than two weeks, the Obama administration indicated on Monday that some long-awaited upgrades to the government's health insurance website could take more time before they're customer-ready. At issue is a new doctor look-up tool for, as well as another feature that would allow consumers to find out whether a particular health plan covers their prescription drugs. Up to now, digging out that information has required additional steps. (10/19)

The New York Times: Many Low-Income Workers Say ‘No’ To Health Insurance
When Billy Sewell began offering health insurance this year to 600 service workers at the Golden Corral restaurants that he owns, he wondered nervously how many would buy it. Adding hundreds of employees to his plan would cost him more than $1 million — a hit he wasn’t sure his low-margin business could afford. His actual costs, though, turned out to be far smaller than he had feared. So far, only two people have signed up. (Cowley, 10/19)

The New York Times: Judge Denies Obama Administration Quick Appeal In House Suit Against Health Care Law
Speaker John A. Boehner may be having trouble with conservative House Republicans, but he is on a bit of a roll in the federal lawsuit brought against the Obama administration over the new health care law. Judge Rosemary M. Collyer of Federal District Court on Monday denied the Obama administration’s request for an immediate appeal of her ruling that the House had the standing to sue the administration. The House says the law includes billions of dollars for new health insurance subsidies that were never authorized by Congress. (Hulse, 10/20)

The Associated Press: Judge: No Quick Appeal In House Lawsuit Over Health Care Law
A federal judge granted a procedural victory Monday to House Republicans using the courts to attack President Barack Obama's health care law, denying an Obama administration request for a quick appeal of a recent ruling in the case. U.S. District Court Judge Rosemary M. Collyer ruled last month the House could continue pursuing its claim that the administration is unconstitutionally spending money that Congress has not appropriated for the health law. On Monday, she turned down an administration request to swiftly appeal that ruling to the U.S. Court of Appeals for the District of Columbia Circuit. (10/19)

The Wall Street Journal's Law Blog: Obama Administration Loses Bid For Early Review Of House GOP Lawsuit
A federal judge has rejected a request by the Obama administration for permission to immediately appeal last month’s ruling that allowed House Republicans to pursue their lawsuit against the 2010 health-care law. Last month U.S. District Judge Rosemary Collyer allowed House Republicans to proceed with parts of their Obamacare lawsuit, ruling that the House has legal standing to bring claims alleging the Obama administration overstepped its bounds in how it’s paying for portions of the health law. In doing so, the judge rejected the Obama administration’s argument that the court should not referee such a dispute between the legislative and executive branches. (Gershman, 10/19)

The Washington Post: House Republicans Under Pressure To Move Debt Limit Bill This Week
Speaker John Boehner is facing growing pressure to start work this week on a bill to increase the federal borrowing limit as the debt ceiling deadline fast approaches amid the continuing uncertainty over who will succeed the Ohio Republican at the end of the month. ... publicans in both the House and Senate have pushed for changes to mandatory spending programs — such as Social Security, Medicare and Medicaid — in exchange for a long-term debt limit increase. But time for those negotiations is running short and Democrats, including President Barack Obama, have made clear they will only support a clean increase. (Snell, 10/19)

The Wall Street Journal: Marco Rubio Latest To Speak Out On Prescription Drug Prices
U.S. Senator Marco Rubio (R-Fla.) became the latest presidential candidate to speak out on prescription drug prices, saying that some pharmaceutical companies are engaging in “pure profiteering” and that high prices threaten to “bankrupt our system.” At a campaign event in New Hampshire last week, a member of the audience asked Sen. Rubio to characterize his “free-market solution” to bringing down the high-cost of lifesaving medicines, according to a video of the event posted online. A spokesman for Sen. Rubio said the exchange occurred at a campaign house party on October 14. (Walker and Haddon, 10/19)

The Wall Street Journal: Outpatient Medical Care Prices Are Rising, Study Shows
As hospitals have acquired more doctor practices, prices for outpatient medical services have gone up, according to a new study that will fuel debate over the impact of the merger boom sweeping through health care. The new study, in the journal JAMA Internal Medicine, looked at what happened to the cost and volume of health-care services as physicians became more integrated into hospitals, by working for them or selling their practices to hospital systems. Overall, outlays for inpatient stays didn’t change significantly, but spending on outpatient care increased. (Wilde Mathews, 10/19)

The New York Times: Drug Makers Sidestep Barriers On Pricing
The pain reliever Duexis is a combination of two old drugs, the generic equivalents of Motrin and Pepcid. If prescribed separately, the two drugs together would cost no more than $20 or $40 a month. By contrast, Duexis, which contains both in a single pill, costs about $1,500 a month. (Pollack, 10/19)

The Wall Street Journal: Drug Firms Buy Pricey Vouchers To Speed Products To Market
There is a new price surge in the pharmaceutical industry—for a limited number of government-issued vouchers that drug makers including AbbVie Inc. and Sanofi SA are buying to speed products to market. Legal provisions enacted in 2007 and 2012 require the U.S. Food and Drug Administration to issue “priority review vouchers” as rewards to developers of drugs for rare pediatric conditions or tropical diseases like malaria. Congress intended the vouchers to encourage more research into underfunded diseases. Companies receive them when the FDA approves their drug for sale, and can redeem them to speed FDA consideration of a subsequent drug for any disease. (Loftus, 10/20)

The Wall Street Journal: Luxury Health Benefits For Top Corporate Bosses On The Wane
For years executives at Brocade Communications Systems Inc. were treated to a full day of physical exams and assessments in the high-end, spa-like setting of Stanford University’s executive medicine program at a cost of several thousands of dollars per executive. But the firm ended the perk in 2013, in an effort to eliminate inequalities in its employee benefits package and avoid taxes and penalties associated with the Affordable Care Act. (Chasan, 10/19)

The Wall Street Journal: Millennium Health Settles Federal Allegations For $256 Million
Millennium Health agreed to pay $256 million to resolve government allegations that it billed Medicare for unnecessary tests. The company’s owners, including private-equity firm TA Associates Management LP and company founder James Slattery, plan to cover the federal settlement and make a separate payment to creditors, according to people familiar with the matter. (Jarzemsky and Weaver, 10/19)

NPR: Suing A Nursing Home Could Get Easier Under Proposed Federal Rules
As Dean Cole's dementia worsened, he began wandering at night. He'd even forgotten how to drink water. His wife, Virginia, could no longer manage him at home. So after much agonizing, his family checked him into a Minnesota nursing home. "Within a little over two weeks he'd lost 20 pounds and went into a coma," says Mark Kosieradzki, who was the Cole family's attorney. Dean Cole was rushed to the hospital, says Kosieradzki, "and what was discovered was that he'd become totally dehydrated. They did get his fluid level up, but he was never, ever able to recover from it and died within the month." (Jaffe, 10/19)

The New York Times: Talk Therapy Found To Ease Schizophrenia
More than two million people in the United States have a diagnosis of schizophrenia, and the treatment for most of them mainly involves strong doses of antipsychotic drugs that blunt hallucinations and delusions but can come with unbearable side effects, like severe weight gain or debilitating tremors. Now, results of a landmark government-funded study call that approach into question. (Carey, 10/20)

The Wall Street Journal: Connecticut Gov. Malloy Calls For Bipartisan Talks To Close Budget Gap
The discussions, if successful, would set up a special legislative session to approve the spending cuts to balance the budget. ... In September, the governor’s budget office said it revised its revenue estimates on capital gains taxes due to a poorly performing stock market and proposed closing the $103 million shortfall in part by cutting $63.5 million in Medicaid reimbursements to hospitals. In addition to hospitals, both Democrats and Republicans criticized those cuts, saying they would hurt health care in Connecticut. Mr. Malloy’s budget office responded by providing another $14.1 million to six smaller hospitals in the state. (DeAvila, 10/19)

The Washington Post: Californians Gained The Right To Die, But The Terminally Ill Who Wanted It Have To Wait
Eventually, the law will permit doctors to prescribe life-ending drugs to terminally ill patients who meet certain requirements: California residency; repeated requests, both verbal and written, for the drugs; and a determination that the patient is mentally fit to make such a decision. Its passage was a major victory for a movement that has sought for decades to gain traction in state legislatures. The California law quadruples the share of Americans living in states where physician-assisted suicide is permitted. The others are Oregon, Montana, Vermont and Washington. (Chokshi, 10/19)

Los Angeles Times: Planned Parenthood Video Fallout: Texas Defunds Group; Court Orders Louisiana To Pay
A video campaign aimed at Planned Parenthood continued to ripple through women’s health services Monday, as Texas officials announced that the Lone Star State would eliminate funding for the organization on the same day a federal court halted efforts in Louisiana to do the very same thing. The grisly videos released earlier this year by the Center for Medical Progress sought to paint Planned Parenthood as illegally selling fetal tissue for medical research – allegations that the reproductive health provider vehemently denied. (LaGanga, 10/19)

The Washington Post: Texas Cancels Contracts With Planned Parenthood
In letters to all Planned Parenthood affiliates in the state, the state health department’s inspector general said the videos persuaded them that the organization was “no longer capable of providing medical services in a professionally competent, safe, legal, and ethical manner.” (Somashekhar, 10/19)

The Associated Press: Texas Cuts Off Medicaid Funding To Planned Parenthood Clinics
Texas announced Monday that it was cutting off Medicaid funding to Planned Parenthood clinics following undercover videos of officials discussing fetal tissue, potentially triggering a legal fight like the one unfolding in neighboring Louisiana. Planned Parenthood affiliates statewide were told in a letter that their enrollment in the joint state-federal Medicaid program was in the process of being terminated because they were potentially “liable, directly or by affiliation, for a series of serious Medicaid program violations.” (10/19)

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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