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KHN First Edition: October 28, 2015


First Edition

Wednesday, October 28, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Health Law Increases Coverage Rates For Women Not Yet Pregnant
Kaiser Health News staff writer Lisa Gillespie reports: "The Affordable Care Act brought health insurance to 5.5 million women over the past two years, but many women still tell of unmet health care needs that could pose risks for them or future pregnancies, a new report finds. Researchers from the Urban Institute and the March of Dimes Foundation underscored the ACA’s long-term potential to improve health care for women in their child-bearing years, 18 to 44. The report was released Tuesday." (Gillespie, 10/27)

Kaiser Health News: Poll: Majority Of Americans Agree That The FDA Should Review Drug Ads Before They Air
Kaiser Health News staff writer Shefali Luthra reports: "There’s been a bipartisan outcry over the rising cost of prescription drugs – for instance, presidential candidates from both parties have identified high drug prices as a major concern. But there’s been far less discussion surrounding government oversight of how those medications are marketed to consumers and doctors. According to a poll released Wednesday by the Kaiser Family Foundation, almost 90 percent of people surveyed think the Food and Drug Administration should review prescription drug ads before they air – something it currently doesn’t do – to make sure they’re clear and accurate. (KHN is an editorially independent program of the foundation.) Those findings held true across political affiliations." (Luthra, 10/28)

NPR: Some Health Plans Have No In-Network Doctors In Key Specialties
Say you bought health insurance through the federal health exchange, paid the premiums and followed the rules. And then say you start having pain in your hands. Your doctor refers you to a rheumatologist to test for arthritis. But when you search for the specialist, there isn't one there. That happens more often than you'd think. In fact, as many as 14 percent of health plans sold on the federal government's insurance exchange are missing doctors in at least one common specialty from their networks, according to a study published Tuesday in JAMA, the journal of the American Medical Association, by researchers at Harvard's T.H. Chan School of Public Health. (Kodjak, 10/27)

The New York Times: Agreement Is Seen As Short-Term Relief For Medicare And Social Security
The budget agreement reached by congressional leaders and the White House this week will prevent a sharp increase in Medicare premiums for more than 15 million older Americans and a deep cut in Social Security benefits for nine million disabled workers, but it will not alter the long-term financial outlook for either program, lawmakers and budget experts said Tuesday. (Pear, 10/27)

Los Angeles Times: No 'Grand Bargain,' But The Budget Pact Is A Big Deal For Millions Of Americans
The two-year budget deal that congressional leaders negotiated with the White House may not be the kind of sweeping accord that House Speaker John A. Boehner and President Obama once tried to hammer out, but its provisions will directly affect the lives of millions of Americans. Senior citizens will be spared a 52% increase in Medicare premiums that would otherwise have taken effect next year. The Social Security disability system will be shored up for a decade, ending the threat of a 20% reduction next year in benefits for the disabled. And rather than being cut once again, spending will increase at the Pentagon and on domestic programs, including medical research and Head Start preschool programs. That last point, in particular, represents a setback for congressional Republicans, who have campaigned for a steady shrinking of most government functions. (Mascaro, 10/27)

The Wall Street Journal: Budget Deal Stirs Anger On The Right
Congressional leaders worked Tuesday to marshal support for a sweeping budget and debt deal that offered an end to fiscal fights with President Barack Obama but opened up top Republicans to criticism from conservatives, including GOP presidential hopefuls. ... For Republicans, the deal offered a path for the GOP-controlled Congress to avert blame from a potential default, instead securing at least some policy goals as a condition for raising the borrowing limit. ... The agreement incorporates measures aimed at extending the solvency of the Social Security program used to help support disabled people. The deal also would prevent an expected 52% increase in premiums for roughly 30% of the people enrolled in Medicare Part B, which covers outpatient care such as doctor visits. (son and Timiraos, 10/27)

The Wall Street Journal: Budget Deal Tackles Disability, Halts Medicare Premium Increase
The budget deal hammered out between the White House and congressional leaders Monday would stave off an unprecedented increase in 2016 Medicare premiums for millions of seniors and prevent a Social Security program for the disabled from becoming insolvent next year. Both are issues that have vexed Congress in recent months. Legislators had wanted to shore up the disability fund before its expected depletion at the end of next year, given the difficulty of addressing entitlements in an election year. The White House achieved its goal of keeping the program solvent and House Republicans won sought-after reforms. (Armour, 10/27)

The Washington Post: House Advances Budget Bill Ahead Of Potential Wednesday Vote
The deal hit a snag Tuesday night after many Republicans raised questions about whether the $80 billion in spending increases in the legislation would be fully offset by spending cuts and other revenue. Conservatives continued to fight the bill throughout the night, including attempting to kill the bill in a late-night hearing of the House Rules Committee. But Republican leaders worked out last-minute fixes that cleared the way for a Wednesday vote. (Snell, 10/27)

The New York Times' DealBook: Walgreens To Buy Rite Aid For $9.4 Billion
As companies throughout the universe of the health care industry accelerate the pace of consolidation, two of the country’s biggest drugstore chains have agreed to combine to create a new giant. Walgreens Boots Alliance said on Tuesday that it would buy Rite Aid for more than $9.4 billion in cash, significantly bolstering its influence with drug makers and pharmacy benefit managers. (de la Merced and Tabuchi, 10/27)

The Wall Street Journal: Walgreens, Rite Aid Unite To Create Drugstore Giant
The deal, which would unite two of the country’s three biggest drugstore owners, would be likely to draw scrutiny from antitrust regulators, who could demand divestitures in exchange for their approval. It also adds to a blockbuster year for health-care mergers and acquisitions, helping to put 2015 on track to be the busiest year ever for M&A. Including assumed debt, the transaction is valued at $17.2 billion. Rite Aid’s debt totaled $7.4 billion in August. (Mattioli , Siconolfi and Cimilluca, 10/27)

The Associated Press: Anthem Beats Street 3Q Forecasts
Anthem Inc. (ANTM) on Wednesday reported third-quarter profit of $654.8 million. The Indianapolis-based company said it had profit of $2.43 per share. Earnings, adjusted for non-recurring costs and amortization costs, were $2.73 per share. (10/28)

The Wall Street Journal: Novartis Profit Hurt By U.S. Settlement
Novartis AG said Tuesday that third-quarter profit fell 42% from the same period last year, as the Swiss drug company settled claims that it paid rebates to encourage specialty pharmacies to increase prescriptions. The Basel, Switzerland-based pharmaceuticals company said it has agreed to pay $390 million as part of a settlement with the U.S. Justice Department regarding claims that the company induced specialty pharmacies to boost prescriptions for Novartis drugs by paying kickbacks in the form of rebates. (Roland and Letzing, 10/27)

The Wall Street Journal: Rising Fees Pinch Some Pharmacies
A sharp rise in fees associated with a popular type of drug plan is chipping away at pharmacies’ profits across the U.S. ... These fees, known as DIR for direct and indirect remuneration, are a small piece of the tangle of contracts, rebates and reimbursements involved in the sale of prescription drugs in the U.S., which totaled $374 billion in 2014, according to the IMS Institute for Healthcare Informatics, a research group. (Ziobro, 10/28)

Politico: Budget Deal Will Be 'Pinata' During GOP Debate
The bipartisan congressional budget deal will be an easy target for the GOP presidential field during Wednesday’s prime-time debate. And GOP leaders are bracing for their carefully crafted work to be treated like a punching bag. ... The deal actually will be good news for the eventual GOP nominee, taking presidential year shutdown and default threats off the table. (Everett, 10/28)

The Wall Street Journal: Jeb Bush Outlines Social Security, Medicare Overhauls
Former Florida Gov. Jeb Bush outlined a package of changes to limit the rising costs of Social Security and Medicare, including scaling back retirement benefits for wealthier Americans. ... On Medicare, Mr. Bush proposed a model similar to one offered by Rep. Paul Ryan, (R., Wis.), the chairman of the House Ways and Means Committee. He called for a “premium-support” plan that allows Americans to choose private insurance plans or to enroll in traditional Medicare. The government would then contribute a set amount toward the insurance premium. (Timiraos, 10/27)

The Associated Press: Bush Proposes Overhaul Of Social Security, Medicare
Republican presidential candidate Jeb Bush is proposing significant changes to Social Security and Medicare to keep the costly federal entitlement programs on solid financial footing. Bush outlined his proposals on the website on Tuesday, the day before the third Republican presidential debate, in Colorado. (10/27)

Poltiico: Bush Follows Paul Ryan On Medicare Overhaul
Bush’s plan would transform Medicare into a premium support program, adopting one of Rep. Paul Ryan’s most controversial budget ideas to give beneficiaries a set amount of money to purchase either a private insurance plan or traditional Medicare. But Democrats have demonized Medicare privatization plans the past two election cycles as shredding the safety net and cast Republican backers as granny killers. (Cook, 10/27)

The Wall Street Journal: For John Kasich, Medicaid Expansion Is Both Accomplishment And Liability
As John Kasich struggles to gain traction in the GOP presidential race, one of his biggest accomplishments as Ohio governor—an expansion of health insurance for the poor—is looming as one of his biggest political liabilities. The issue of expanding Medicaid was raised in the very first question to Mr. Kasich in the first Republican presidential debate in August, and it may re-emerge during Wednesday’s debate in Colorado, where Mr. Kasich is under heavy pressure to deliver a breakout performance. (Hook, 10/27)

The Associated Press: Drug Prices Top Americans’ List Of Health Care Concerns
Americans from across the political spectrum are worried about the cost of prescription drugs for serious diseases, following weeks of news coverage about companies hiking prices for critical medicines. Keeping drugs for cancer, hepatitis, HIV and other conditions affordable is the top health priority for Democrats, Republicans and independents, according to a poll released Wednesday by the nonpartisan Kaiser Family Foundation. (Perrone, 10/28)

Los Angeles Times: More Middle-Class Americans Visit Mexico For Low-Cost Medical Care
A new study from the Commonwealth Fund, a private foundation that aims to promote a high-performing health care system, revealed that about 23 percent of Americans with coverage are considered underinsured up from 12 percent in 2003 since the inception of Obamacare in 2012. That means roughly 31 million Americans who bought health insurance still have trouble affording treatment under their policies, according to the study. (D'Angelo, 10/27)

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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