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KHN First Edition: November 9, 2015

KHN

First Edition

Monday, November 09, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: ‘Do The Math’ When Shopping For A Health Plan This Open Enrollment Season
Kaiser Health News staff writer Julie Appleby reports: "With the health insurance markets open for next year’s enrollment, Eve Campeau says she’s planning to look carefully at the fine print. Last time she shopped, she switched to a plan with a lower monthly premium, but found herself paying far more out-of-pocket for medications and doctor visits. While she might be saving money on the premium, she is reluctant to go to seek medical care because of the up-front cost." (Appleby, 11/9)

Kaiser Health News: Consumer Confusion Continues In Obamacare’s Third Year
WNYC's Fred Mogul, working in partnership with Kaiser Health News and NPR, reports: "Recording and mixing music is Vernon Thomas’ passion, but being CEO and producer of Mantree Records is not his day job. He’s an HIV outreach worker for a local county health department outside Newark, N.J. He took what was to be a full-time job in May because the gig came with health insurance – and he himself has HIV, the virus that causes AIDS. But then the county made it a part-time job – and Thomas lost that coverage before it started." (Mogul, 11/9)

Kaiser Health News: Calif. Medicaid Patients With Cancer Fare Worse Than Those With Other Coverage
Reporting for Kaiser Health News, Barbara Feder Ostrov writes: "Cancer patients insured by California’s health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers. While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC-Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer." (Feder Ostrov, 11/6)

Kaiser Health News: Using A Weight-Loss App? Study Says It Doesn’t Help Much
Kaiser Health News' Lynn Shallcross reports: "Young American adults own smartphones at a higher rate than any other age group. Researchers from Duke University wanted to see if capitalizing on that smartphone usage with a low-cost weight-loss app might help the 35 percent of young adults in the U.S. who are overweight or obese. If you’re rooting for smartphones to solve all our health problems, you’re not going to like what the researchers found. The smartphone app didn’t help young adults lose any more weight than if they hadn’t been using the app at all." (Shallcross, 11/6)

The New York Times: Regulators Urge Broader Health Networks
The nation’s insurance commissioners are recommending sweeping new standards to address complaints from consumers about limited access to doctors and hospitals in health plans sold under the Affordable Care Act. Limited networks of health care providers are a feature of many insurance policies offered in the public marketplaces, or exchanges, where people with low incomes can often obtain subsidies that reduce their monthly premiums to $100 or less. Such “narrow networks,” consumers say, often do not include the doctors they need for specialized care for themselves or their children. (Pear, 11/8)

USA Today: Health Insurance Is A Tough Sell When Tax Credits Are Low
Those eligible for the lowest subsidies to buy health insurance were the least likely to sign up for 2015 plans, studies show, another indication of the challenge of boosting enrollment for President Obama's signature health care law in 2016. The percentage of those choosing health plans dropped from about 75% for those earning $23,540 to about 14% for those earning about $47,000, new research from the Urban Institute and the Robert Wood Johnson Foundation (RWJF) shows. Premium tax credits available on the federal and state insurance exchanges decrease as consumers earn closer to 400% of the federal poverty limit, which is about $47,000 for an individual. (O'Donnell, 11/6)

The Washington Post: The Controversial Part Of Obamacare That Even GOP-Led States Are Keeping
Republican-led states that expanded Medicaid are sticking with the change, despite qualms and intense political pressure within the GOP about embracing a key part of President Obama’s health-care law. GOP governors and legislators have balked at repealing expansion partly because of the benefit of providing federally funded health insurance to large numbers of constituents, analysts say. They also wish to keep the billions of dollars of federal funds that the Affordable Care Act (ACA) — also called Obamacare — gives states that broaden Medicaid. (McCartney, 11/6)

The New York Times: New Yorkers Face Hard Decisions After Collapse Of Health Republic Insurance
Health Republic and the 11 other co-ops set to close this year make up more than half of the total plans established under the Affordable Care Act. The 23 organizations — nonprofit start-ups with consumer-led boards — were set up as alternatives to government-run plans and were intended to create competition with companies like Aetna and Anthem. The plans took off but soon encountered financial and political difficulties. ... Congress also made deep cuts to the funds meant to boost struggling co-ops, reducing that budget by 60 percent. Health Republic has now become a cautionary tale and a warning to other struggling insurers. The company has also become a source of anxiety, from Albany to Long Island, as some New Yorkers try to determine what insurance plan to sign up for next. (Casey, 11/6)

USA Today: Obama Says He'll Visit City With Most Obamacare Sign-Ups
President Obama wants YOU to help get more people signed up for Obamacare. Beginning the third year of open enrollment on the public health insurance exchanges created under the Affordable Care Act, the White House is rolling out a new strategy to boost participation above the elusive 10 million mark. (Korte, 11/7)

The New York Times: Supreme Court To Hear New Case On Contraception And Religion
The Supreme Court on Friday once again entered the conflict between religious freedom and access to contraception, taking up a case about whether some religious employers must provide free insurance coverage for birth control. The new case concerns religious objections to a requirement under the Affordable Care Act that employers provide coverage for contraception to their female workers or face fines. Houses of worship, including churches, temples and mosques, are automatically exempt from the requirement and do not have to file any paperwork. But the new case concerns a second category of institutions — nonprofit groups like schools and hospitals that are affiliated with religious organizations. (Liptak, 11/6)

The Wall Street Journal: Supreme Court To Review Contraception Compromise In Health Law
The Supreme Court Friday agreed to again review Affordable Care Act contraceptive-coverage requirements, accepting challenges from Christian institutions who say arrangements crafted for them by the Obama administration are inadequate to address their birth-control objections. ... The court will review whether the contraception rules are at odds with a federal law on religious freedom, thrusting a contentious social issue further into the limelight in an election year and raising the prospect of further changes to the health law. (Kendall and Radnofsky, 11/6)

Los Angeles Times: U.S. Supreme Court Dives Back Into The Fight Over Contraceptives And Obamacare
The Obama administration has stood fast on the so-called contraceptive mandate, insisting that women employees and students must have access to birth control through their insurance. Providing contraceptives free of charge will greatly reduce unwanted pregnancies and abortions, they say. And, they argue, it's one thing for the religious institutions to say they should not be required to pay for contraceptive coverage. It's quite another for them to refuse even to notify the government so that other arrangements can be made. (Savage, 11/6)

The Washington Post: Supreme Court Accepts Challenge To Health Law’s Contraceptive Mandate
The Obama administration says it has provided the organizations with an easy way to opt out of the legal requirement that employers include contraceptives as part of health insurance coverage. Employers who object must make clear their religious objections and let insurance companies and the government take over from there. But the groups say even that step would implicate them in what they believe to be a sin, adding that they face ruinous fines if they refuse to comply. They want to be included under the blanket exemption from providing the coverage that the government has extended to churches and solely religious groups. (Barnes, 11/6)

Politico: Supreme Court To Take Up Challenge To Obamacare's Contraception Mandate
The case represents yet another trip for the Affordable Care Act before the justices since the law's passage more than five years ago — and this one could represent another Obamacare-Supreme Court flash point in an election year. But unlike some of the earlier Obamacare challenges, a ruling against the administration would not cripple the legislation. The law's major provisions, such as the health insurance exchanges, the subsidies and Medicaid expansion, would be unaffected. (Haberkorn, 11/6)

The Wall Street Journal: U.S. Targets Pharmacies Over Soaring Claims To Military Health Program
Federal prosecutors in at least four states are mounting investigations into what they describe as widespread fraud by compounding pharmacies in claims to the health-insurance program that covers 9.5 million U.S. military members and their families. In the latest move, four Florida pharmacies last month agreed to pay $12.8 million combined to settle civil allegations that they falsely billed the insurance program Tricare for expensive pharmaceutical creams and gels to treat pain, scars and other ailments, according to A. Lee Bentley III, the U.S. attorney for the Middle District of Florida. (Walker, 11/8)

The Wall Street Journal: Lilly, Merck And Valeant Receive Inquiries About Drug Pricing
The U.S. Attorney’s Office for the Eastern District of Pennsylvania and the Justice Department’s civil division are seeking information from Valeant Pharmaceuticals International Inc. and Eli Lilly & Co. about how they calculate and report drug prices for the Medicaid rebate program, the companies disclosed in filings to the Securities and Exchange Commission in recent weeks. (Loftus, 11/6)

Los Angeles Times: Blast From The Past: Doctor House Calls. An App, Heal, Facilitates Them.
Within five weeks, Dua's entrepreneur husband had developed an Uber-like app that would allow a doctor to be sent to someone's home or office at an hour's notice. The service — Heal — launched in February and thus far has raised $6.5 million from investors who include Qualcomm Executive Chairman Paul Jacobs, United Talent Agency Managing Director Jay Sures and entertainer Lionel Richie. It has a network of 100 doctors in Los Angeles County, Orange County, San Francisco and Silicon Valley who offer house calls at a flat rate of $99 per patient. (Daswani, 11/7)

NPR: Doctor Treats Homebound Patients, Often Unseen Even By Neighbors
Although Miller's practice may harken back to the country doctor of decades past, it could be the future of medicine. In 2013, about 2.6 million Medicare claims were filed for patient home visits and house calls. That's up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics. The trend is expected to accelerate as baby boomers grow older. One in 20 people over the age of 65 is homebound in the U.S., according to a study published in July in JAMA Internal Medicine. (Friedman, 11/8)

Reuters: Health Insurer Cigna Reports Better-Than-Expected Profit
Health insurer Cigna Corp reported a better-than-expected quarterly profit, helped by higher enrollments in its government plans and favorable medical costs. Cigna, which agreed to be bought by larger rival Anthem Inc in July, also raised the low end of its forecast for full-year adjusted earnings to $8.40 per share from $8.30. The company kept the top end of the guidance unchanged at $8.60. However, Cigna said it expected revenue growth in 2016 could be offset by reduction in customers in its individual plans, which are sold on exchanges created under the U.S. Affordable Care Act. (Penumudi, 11/6)

The Wall Street Journal: Humana Reports Profit Growth As Medicare Membership Rises
Humana Inc., which in July agreed to be acquired by rival Aetna Inc., on Friday said Medicare membership growth lifted third-quarter profit. Strength in health care services, driven by Medicare, offset a soft commercial segment. Chief Financial Officer Brian Kane said the insurer expects “marked improvement” in the Medicare and individual commercial businesses next year, but added that Humana remains cautious about 2016 earnings growth expectations due to challenges in those segments. (Beilfuss, 11/6)

The Washington Post: Warning: Health Coverage For Two Can Cost More Than For Larger Families For Thousands
So some folks were startled to learn that the new “self plus one” option in the Federal Employees Health Benefits (FEHB) program can be more expensive than family coverage, depending on the company. This option allows enrolled federal workers and retirees to purchase health insurance for themselves and one eligible family member. Open season, when health plans can be chosen, begins Monday and runs through Dec. 14. With health insurance costs for FEHB participants rising by an average of 7.4 percent next year, the most since 2011, enrollees are looking for any break they can get. Unfortunately for older people, health-care expenses rise with age and they are more likely to want self-plus-one policies. (Davidson, 11/8)

The Associated Press: VA Secretary Says Demand Outstripping Extra Resources
Veterans' hospitals and clinics are beefing up staff and seeing more patients, but the number of appointments not completed within 30 days continues to grow, Department of Veterans Affairs Robert McDonald said Friday. Speaking at the National Press Club in advance of Veterans Day, McDonald described a VA that is doing much to address problems that investigators say caused chronic delays for veterans seeking care. (Freking, 11/6)

The Washington Post: Scientist Falsified Data For Cancer Research Once Described As ‘Holy Grail,’ Feds Say
One Duke University surgeon called it a “new frontier” in cancer treatment. Another said it could save “10,000 lives a year” or more. A researcher at Mass General Hospital called it “a very, very exciting tool” in the fight against lung cancer. As news spread in 2006 and 2007 of the work of Anil Potti, a star cancer researcher at Duke, the excitement grew. What he had claimed to achieve, in leading medical journals, was a genomic technology that could predict with up to 90% accuracy which early stage lung cancer patients were likely to have a recurrence and therefore benefit from chemotherapy. (Barbash, 11/9)

The Associated Press: Powerful New GOP House Chairman Had Early Democratic Roots
Brady, from a solidly Republican district north of Houston, headed the trade subcommittee until 2013. That's when he took over the health subcommittee and helped lead many of the House's GOP's repeated, unsuccessful efforts to roll back President Barack Obama's health care law. As chairman, Brady's portfolio is much wider. (11/8)

The Hill: Party Leaders Send Women Into Committee Brawl Over Abortion
Republicans and Democrats have stacked a new select committee on Planned Parenthood with their fiercest fighters on abortion rights, setting the stage for a major election-year battle. Unlike every other committee in Congress, the overwhelming majority of lawmakers on the panel are women, with Rep. Marsha Blackburn (R-Tenn.) serving as chairwoman and Rep. Jan Schakowsky (Ill.) serving as the ranking Democrat. (Marcos and Ferris, 11/7)

The Associated Press: Pa. GOP Rep. Joe Pitts To Retire
Pennsylvania Republican Rep. Joe Pitts announced Friday he will not seek re-election and will retire at the end of his 10th term. Pitts, 76, is one of the House's most ardent conservatives on social issues such as abortion. As chairman of a key health panel on the powerful Energy and Commerce Committee, Pitts helped pass legislation earlier this year to fix a broken Medicare reimbursement system for physicians and is a co-author of bipartisan legislation boosting medical research. (11/6)

The Washington Post: Clinton Joins Democratic Rivals In Backing Change To Marijuana Classification
Hillary Rodham Clinton has long declined to endorse legalized medical or recreational marijuana at the federal level, but on Saturday, she added more specifics to her proposal to increase research into medical marijuana. Clinton said that she supports removing marijuana from a list of schedule 1 drugs, a classification that prevents federally-sponsored research into its effects. As a schedule 1 drug, marijuana is classified among the most dangerous drugs that the federal Drug Enforcement Agency regulates. (Phillip, 11/7)

The Washington Post: Why Conservatives Listen To Carson’s Pitch Of Dietary Supplements
The last time Ben Carson stepped onto a debate stage, he was asked about something he had never really questioned. Why had he endorsed the nutritional products of Mannatech, a Texas-based company that was forced to settle a 2009 wrongful marketing lawsuit? What did that endorsement say about his “judgment”? ... Yet, in defiance of the facts, Carson professed ignorance on the debate stage about any “relationship” with the company. He spent two days following the debate denouncing the questions about Mannatech as “propaganda.” And his most ardent supporters don’t care. (Weigel, 11/7)

The Washington Post: Virginia Governor Terry McAuliffe Says He Has A No-Cost Way To Expand Medicaid
Gov. Terry McAuliffe intends to make another push for Medicaid expansion despite intense opposition from Republicans, who retained full control of the General Assembly in elections last week. McAuliffe (D) said he will pursue a new strategy that he thinks will be more palatable to conservatives — one that he said would allow Virginia to extend health-care benefits to 400,000 uninsured citizens at no cost to the state. (Vozzella, 11/7)

The Associated Press: Bevin To Roll Back Health Reform, Alter Marriage Licenses
Bevin also said Friday he would dismantle kynect, Kentucky's state-run health insurance exchange, by the end of 2016. More than 100,000 people have used kynect to purchase private health insurance plans with the help of federal subsidies. Instead, Bevin wants those people to buy health insurance from an exchange run by the federal government. "(Kynect) adds nothing of value," Bevin said. "It is a redundancy that we as taxpayers in this state are paying for twice." State health officials disagree, arguing kynect was designed specifically for Kentucky and has helped slash the share of uninsured state residents from about 20 percent in 2013 to 9 percent by 2015. But most of that reduction came because more people qualified for the state's expanded Medicaid program. (Beam, 11/6)


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