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KHN First Edition: October 30, 2015


First Edition

Friday, October 30, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Exchanges Face Sign-Up Challenges As Health Law’s 3rd Open Enrollment Begins
Kaiser Health News staff writer Phil Galewitz reports: "On fishing piers in Maine, inside public libraries in rural Iowa and at insurer-run retail stores in Minnesota, the hunt for uninsured Americans will reignite Sunday when Obamacare’s third open enrollment season starts. But the job will be more difficult this time as the number of uninsured Americans has fallen dramatically." (Galewitz, 10/30)

Kaiser Health News: Costs May Keep Low-Income Patients From Clinical Trials, Study Finds
Kaiser Health News consumer columnist Michelle Andrews writes: "Cancer patients with lower incomes are a third less likely to be part of clinical trials that could help treat their disease than those whose annual income is at least $50,000, according to a new study. Cancer patients with lower incomes are a third less likely to be part of clinical trials that could help treat their disease than those whose annual income is at least $50,000, according to a new study." (Andrews, 10/30)

Kaiser Health News: Feds Issue Proposed Rule On Health Information Collected By Workplace Wellness Programs
Kaiser Health News staff writer Julie Appleby reports: "Federal regulators on Thursday announced a proposed rule allowing voluntary employer workplace wellness programs to ask for health information, including some limited genetic details, from participants and their spouses. According to a statement by the Equal Employment Opportunity Commission, the agency “is mindful that this change creates an exception to the general rule that no incentives may be provided for an employee’s genetic information. Therefore, the agency has interpreted the exception as narrowly as possible.” The release also notes that this exception does not apply to children." (Appleby, 10/29)

The Washington Post: Third ACA Enrollment Begins With New Ads And Modest Expectations
The insurance exchanges created under the Affordable Care Act are scheduled to open for a third sign-up season Sunday, with the Obama administration setting modest enrollment expectations and focusing its energies on a niche of people who remain uninsured. The impending open-enrollment will be devoid of the movie stars and basketball heroes who served as White House megaphones two years ago, when the online marketplaces debuted. (Goldstein, 10/29)

USA Today: Feds Unveil New Obamacare Ads That Target Low Income Consumers
Federal health officials are targeting low-income consumers with new advertisements unveiled Thursday that emphasize the affordability of health insurance, two days after new data showed the average increase in premiums was higher than for 2015 plans. In a meeting with reporters, Department of Health and Human Services Secretary Sylvia Burwell emphasized that about 80% of consumers shopping on the federal exchange that serves 38 states are eligible for tax credits that lower their premiums to less than $100 a month. (O'Donnell, 10/29)

NPR: Obamacare Deploys New Apps, Allies To Convince The Uninsured
Ten million people still don't have health insurance two years after the Affordable Care Act went into effect. Some never bought a policy. But 20 percent went to the trouble of signing up on, or one of the state insurance exchanges, and even made payments. Then, those 2 million people let their insurance lapse. NPR asked visitors to our Facebook page to tell us why. (Kodjak, 10/30)

The New York Times: Groups Want Federal Health Exchange To Register Voters, Too
When the Affordable Care Act’s new enrollment season begins next month, people seeking health insurance through the online federal exchange will also be offered something they may not expect: a chance to register to vote. But voting rights groups say the offer — a link to a voter registration form that they can print and mail, deep inside the application for health coverage — does not go far enough. This week, the groups accused the Obama administration of violating federal law by not doing more to ensure opportunities for voter registration through the exchange,, which serves 38 states. (Goodnough, 10/29)

The Associated Press: Big Insurers Remain Upbeat On Fledgling ACA Exchanges
Slipping enrollment and struggling competitors have done little to shake the faith that the nation’s biggest health insurers have placed in the Affordable Care Act’s public insurance exchanges. Aetna executives said Thursday that the exchanges, a key element in the overhaul’s push to cover millions of uninsured people, remain a good market, even though the insurer’s enrollment in them fell 11 percent to about 814,000 people in the third quarter. Leaders of the Blue Cross-Blue Shield insurer Anthem have voiced a similar sentiment, and UnitedHealth said earlier this month that it will expand into 11 more exchanges next year. (Murphy, 10/29)

The Associated Press: Cost Of Insurance Under Health Law Likely To Drop
Many Indiana consumers who get their health insurance through the federal health care law can expect to pay less in the coming year, according to estimates from the U.S. Department of Health and Human Services. The cost of health insurance under the President Barack Obama's Affordable Care Act is expected to climb across much of the U.S. — in some cases by double digits. (10/29)

The New York Times: Senate Passes Budget Bill And Sends It To Obama
The Senate approved a crucial bipartisan budget agreement early on Friday that would avert a government default and stands to end nearly five years of pitched battles between congressional Republicans and the Obama administration over fiscal policy. The measure, which was approved 64 to 35, now goes to the White House, where President Obama is ready to sign it. (Herszenhorn, 10/30)

The Wall Street Journal: U.S. Senate Passes Budget Bill, Averting Risk Of Default
Friday’s early morning vote of 64-35 will enact a sweeping deal that came together only days before. Congressional leaders reached an agreement with the White House late Monday increasing spending by $80 billion through September 2017 and increasing the federal government’s borrowing limit until mid-March 2017. ... The latest agreement split Republicans, dividing those who wanted to see higher defense spending from those who said the bill didn’t extract enough spending reductions in exchange for increasing the debt limit. (son, 10/30)

The Wall Street Journal: Congressional Moves May Help Business
A burst of legislative activity in Congress this week, culminating in a two-year budget deal, could lift the cloud of uncertainty and modestly boost the economy by rolling back fiscal austerity. ... Lawmakers also included two important changes that will avert potential payment spikes and benefit cuts for seniors and the disabled. The budget agreement takes steps that will block a 52% jump in Medicare premiums for about 30% of beneficiaries next year. Premiums will now increase by 15% for those beneficiaries. AARP, a lobby for older Americans, praised lawmakers for heading off the premium increase. (Timiraos, 10/29)

USA Today: Senate Approves Two-Year Budget Deal That Prevents Default On Debt
Senate Majority Leader Mitch McConnell, R-Ky., had a harder time convincing Republican senators to support the bill. Many conservatives objected to lifting the budget caps and raising the debt limit. ... By pushing the deal quickly through the House, outgoing Speaker John Boehner, R-Ohio, eased pressure on his successor, Rep. Paul Ryan, R-Wis. Ryan, who was sworn in as the new speaker on Thursday, will not have to begin his tenure by facing an imminent fiscal crisis. (Kelly, 10/30)

The Washington Post: Senate Approves Two-Year Bipartisan Budget Agreement
To offset this cost, negotiators tapped a number of sources, including making changes to Medicare and Social Security, auctioning off government-controlled wireless spectrum, selling crude oil from the Strategic Petroleum Reserve and tightening tax rules for business partnerships. ... The agreement also will prevent a potential 20 percent across-the-board cut to Social Security Disability Insurance benefits scheduled to take place next year, by transferring resources from the main Social Security fund and making changes to the program. The cost-saving revisions include allowing some recipients who can still work to receive partial payments while earning outside income, and expanding a program requiring a second medical expert to weigh in on whether an applicant is legitimately disabled. (Snell, 10/30)

The New York Times: As Speaker, Paul Ryan May Need To Pare Lofty Goals
Paul D. Ryan, a son and grandson of Midwestern lawyers, ascended rapidly in American politics as a man with big plans: to overhaul the tax code, slash federal spending and rewrite the social contracts for Medicare and Social Security. Mr. Ryan, 45, who was elected in a celebratory Capitol Hill pageant on Thursday as the 54th speaker of the House, the youngest to grip the gavel since the late 1860s, now confronts a fundamental question: Will his new post provide a platform to pursue his bold visions for a renewed America, or will those big ideas weigh him down in an era defined by confrontation and small-bore compromises? (Herszenhorn and Huetteman, 10/29)

The Wall Street Journal: House Elects Paul Ryan As New Speaker
Mr. Ryan’s plan to listen to ideas from the rank and file doesn’t mean he takes the gavel without his own policy views, developed through a career that began with odd jobs like mowing lawns and waiting tables and led to chairmanships of two powerful House committees. The most ambitious plans in Mr. Ryan’s idea chest are based on a pull-yourself-up-by-your-bootstraps philosophy that inflames Democrats as much as it energizes Republicans. In closed-door meetings with House Republicans, Mr. Ryan has said he wants to overhaul the tax code, replace President Barack Obama’s health law, and rewrite federal poverty programs—and in the process draw a contrast with Democrats heading into the 2016 presidential election. (Hughes, 10/29)

The Wall Street Journal: Newly Elected House Speaker Paul Ryan Takes Gavel With Focus On Overhauling Taxes
His budget plan, which came to be known as the Ryan budget, called for deep cuts in spending and an overhaul of Medicare. As a head of the tax panel, Mr. Ryan had slated 2016 as the year to roll out his big tax ideas. It remains to be seen if he can use the speaker’s gavel to implement his ideas. His predecessor, Ohio Republican John Boehner, had aimed high in 2011 when he came close to reaching a broad budget deal with President Barack Obama, only to end his tenure with incremental changes that left big fiscal fights unsettled. (McKinnon and Hughes, 10/29)

The Associated Press: Obama And Ryan: Political Foils, Occasional Policy Partners
Still, there’s no doubt that Ryan was the White House’s favored choice for speaker after John Boehner resigned and No. 2 Republican Kevin McCarthy withdrew from the race to succeed him. Aides say the president views Ryan as a policy wonk driven more by legislative results than appeasing GOP hardliners. ... spite these areas of common interest, the most notable exchanges between Obama and Ryan have come when they’ve been at odds. During a televised health care summit in 2010, Ryan derided the president’s health care legislation as rife with “gimmicks and smoke and mirrors” techniques to shade the real cost. His detail-rich, six-minute commentary was praised by Republicans as among the most effective arguments against the “Obamacare” bill. (Pace, 10/29)

The Washington Post: Mental Health In The Spotlight Thursday On Capitol Hill
The federal government's top mental health researcher told lawmakers Thursday that the country needs to do much more to apply research to improve treatments, as a Senate committee heard testimony to address comprehensive mental health legislation. Speaking on his second-to-last day in his job as director of the National Institute of Mental Health, Thomas Insel said his 13-year tenure had convinced him of two “abiding truths.” (Sun, 10/29)

The New York Times' DealBook: Health Care Companies In Merger Frenzy
In a fast-paced financial version of musical chairs, health care companies of all kinds — drug makers, hospital groups and insurers — have been frantically circling to be sure they are not left out of the latest frenzy of deal making. Mergers and acquisitions worth about $270 billion have been announced in the first nine months of 2015 in the United States, easily outpacing the activity in recent years, according to a tally by Mergermarket. On Thursday, Allergan, itself the product of a recent merger, said it was in talks to be bought by Pfizer in a deal that could easily become the year’s biggest deal. Allergan’s current market value is $113 billion. (Abelson, 10/29)

Los Angeles Times: An Allergan-Pfizer Deal Could Be Biggest Merger This Year
Drug giant Pfizer Inc. and Botox maker Allergan confirmed Thursday that they're in early talks to merge in a blockbuster deal that, if completed, would cap a remarkable consolidation wave roiling the U.S. healthcare industry. A deal between the companies — with an expected price tag well above Allergan's current stock market valuation of about $120 billion — would be the largest corporate merger this year. (Peltz and Masunaga, 10/29)

The Associated Press: Pfizer, Allergan In Deal Talks To Create Drug Giant
A merger could enable Viagra maker Pfizer, the world’s second-biggest drugmaker by revenue, to surpass Switzerland’s Novartis AG and regain the industry’s top spot. In separate statements, both companies on Thursday said they were in “preliminary friendly discussions.” Allergan Plc said there’s no certainty that the talks with Pfizer Inc. will lead to a deal. (Johnson, 10/29)

The Wall Street Journal: CVS, Express Scripts, UnitedHealth Group Cut Off Philidor, Pharmacy Used By Valeant
The three largest pharmacy-benefit managers in the U.S. said they are ceasing work with a pharmacy that has helped drive sales growth at Valeant Pharmaceuticals International Inc., dealing another blow to the drug maker. CVS Health Corp. on Thursday said it is terminating mail-order pharmacy Philidor Rx Services LLC from the network of its Caremark pharmacy-benefit unit, after audits found the pharmacy wasn’t complying with terms of its agreement. Express Scripts Holding Co. released a similar statement about an hour later, saying it was cutting off Philidor and also evaluating four additional pharmacies with which Valeant “has a similar relationship.” UnitedHealth Group Inc.’s OptumRx also said it was dropping Philidor from its networks, beginning the process after an audit late last year. (Wilde Mathews, Whalen and Copeland, 10/29)

The Wall Street Journal: Aetna’s Earnings Rise Amid Moderate Medical Costs
As for 2016, Aetna said it was aiming for at least low double-digit earnings growth, saying it sees potential for expansion in Medicare and Medicaid membership. But it flagged challenges including losing some business from large national employers that decided to offer workers plans from multiple insurers. Aetna also said the individual business remained “challenging,” and that it would shrink its footprint in the Affordable Care Act’s marketplaces to 15 states, down from 17 this year. (Wilde Mathews and Steele, 10/29)

The New York Times: The Narrative Frays For Theranos And Elizabeth Holmes
Few people, let alone those just 31 years old, have amassed the accolades and riches bestowed on Elizabeth Holmes, founder and chief executive of the blood-testing start-up Theranos. This year President Obama named her a United States ambassador for global entrepreneurship. She gave the commencement address at Pepperdine University. She was the youngest person ever to be awarded the Horatio Alger Award in recognition of “remarkable achievements accomplished through honesty, hard work, self-reliance and perseverance over adversity.” She is on the Board of Fellows of Harvard Medical School. (Stewart, 10/29)

The Wall Street Journal: Sanofi Recalls Auvi-Q Allergy Injectors
Sanofi SA voluntarily recalled all 2.8 million of its Auvi-Q epinephrine injectors from the U.S. and Canada, sending allergy patients and anxious parents scrambling to replace them with rival EpiPen devices. Millions of allergy sufferers carry epinephrine injectors and administer shots themselves in case of life-threatening anaphylactic reactions. Sanofi said it had received 26 reports of the devices potentially delivering inadequate doses, which could have “significant health consequences,” although no fatalities have been reported. (Beck, 10/29)

The Wall Street Journal's Real Time Economics: Five Revealing Economic Exchanges From The Republican Debate
Several of the candidates, notably Kentucky Sen. Rand Paul, New Jersey Gov. Chris Christie and former Florida Gov. Jeb Bush called for changes that would put Social Security and Medicare on sounder ground by increasing retirement ages, decreasing benefits for higher-income retirees or changing the formula used to calculate living-cost adjustments. Mr. Paul said Medicare was paying out around 2.5 times more per person than it had collected, raising an important point about demographics. “We have this enormous mismatch because we have smaller and smaller families,” he said. Messrs. Bush and Christie have both made the case that Social Security will need to be reoriented towards a program that offers a more progressive payment structure. “The simple way to do it is to make sure that the wealthiest don’t receive the same benefits as the people that are lower-income,” Mr. Bush said. (Timiraos, 10/29)

The Washington Post: Ben Carson’s Health-Care Prescription Is No Cure For What Ails Americans
Ben Carson began rolling out his policy alternatives for the American health-care system this week. Like many prescriptions, it’s a bit difficult to decipher at first glance — though not because of poor handwriting. To put it bluntly, CarsonCare is a muddle. It’s hard to know precisely what he’s proposing when he says, as he did in Wednesday’s debate, that it gives people “the option of opting out” of government health care. But based on what we know, it would neither expand access to health care nor improve quality, nor save a whole lot of money. (Ezekiel J. Emanuel and Andrew Steinmetz. 10/29)

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