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KHN First Edition: November 19, 2015


First Edition

Thursday, November 19, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Cancer Meds Often Bring Big Out-Of-Pocket Costs For Patients, Report Finds
Kaiser Health News staff writer Julie Appleby reports: "Cancer patients shopping on federal and state insurance marketplaces often find it difficult to determine whether their drugs are covered and how much they will pay for them, the advocacy arm of the American Cancer Society says in a report that also calls on regulators to restrict how much insurers can charge patients for medications." (Appleby, 11/19)

Kaiser Health News: California Exchange Offers Dental Coverage To Adults For First Time
Reporting for Kaiser Health News, Barbara Feder Ostrov writes: " Thousands of California adults are signing up for dental insurance offered for the first time by California’s health insurance exchange, Covered California, officials said Wednesday. About 33,000 adults have signed up for the dental plans, including about 6,000 who also are signing up for health insurance on the exchange for the first time, said Lee, Covered California’s executive director." (Feder Ostrov, 11/19)

The Wall Street Journal: Health-Plan Rates Vary Widely, But Most Popular Have Jumped From 2015
For a snapshot of typical insurance prices for 2016 under the health law, The Wall Street Journal examined choices for a midrange “silver” plan through for people who currently have coverage with the most popular insurer in their state. Specific premiums vary based on age, locality, the extent of coverage offered and family size, but pricing trends are generally consistent across plans—including those sold directly to people without using (Radnofsky and Overberg, 11/18)

The Wall Street Journal: Rising Rates Pose Challenge To Health Law
Many people signing up for 2016 health policies under the Affordable Care Act face higher premiums, fewer doctors and skimpier coverage, which threatens the appeal of the program for the healthy customers it needs. Insurers have raised premiums steeply for the most popular plans at the same time they have boosted out-of-pocket costs such as deductibles, copays and coinsurance in many of their offerings. The companies attribute the moves in part to the high cost of some customers they are gaining under the law, which doesn’t allow them to bar clients with existing health conditions. (Radnofsky, Overberg and Armour, 11/18)

The New York Times: Shopping For Health Insurance Is New Seasonal Stress For Many
For 2014, the first year she got health coverage through the Affordable Care Act, Gail Galen chose a plan from a new nonprofit insurer, Oregon’s Health CO-OP. But the price jumped for 2015, so Ms. Galen switched to a policy from a different company, LifeWise Health Plan. Now, with open enrollment for 2016 underway, she is preparing to leap to her third insurer in three years — and stocking up on whiskey, she says, only half in jest, as she braces for another round of shopping on the federal insurance marketplace. (Goodnough, 11/18)

The New York Times: Health Care Law Forces Businesses To Consider Growth’s Costs
Starting in January, the Affordable Care Act requires businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. Ms. Hunter, who has 45 employees, is determined not to cross that threshold. Paying for health insurance would wipe out her company’s profit and the five-figure salary she pays herself from it, she said. ... The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it. (Cowley, 118)

The Washington Post: House Panel Ordered To Comply With SEC ‘Political Intelligence’ Probe
A federal investigation into Washington-style insider trading got the green light to continue this week when a judge ruled that congressional staff must provide information to investigators about possible leaks of sensitive information to investors. ... investigation has focused attention on a relatively new and highly lucrative form of Washington consulting in which “political intelligence” firms leverage their connections on Capitol Hill and inside executive agencies to provide investors with special insights to inform their trading decisions. That Washington-to-Wall Street communication is at the heart of the SEC investigation into the health-insurance stock surge. The episode began after a Washington-based firm, Height Securities, published an alert to clients on April 1, 2013, predicting an imminent change in a rule governing health insurance companies participating in a Medicare program. (Hamburger, 11/18)

The Wall Street Journal: Shares Of Deal Targets Reflect Regulatory Fear
Shares of some high-profile takeover targets are trading at steep discounts to the prices of deals they signed, showing fissures may lurk in the current deal boom. ... Cigna Corp.’s stock is 22% below the value of Anthem Inc.’s $48 billion offer, while oil-field-services provider Baker Hughes Inc. trades 17% cheaper than the price of its pending $35 billion sale to Halliburton Co.​ ... Meanwhile, there have been signs that regulators take a dim view of some of the big pending deals. They are closely reviewing both Anthem’s deal for Cigna and the $34 billion proposed tie-up of Aetna Inc. and Humana Inc. Together, the two deals would trim the number of big health insurers from five to three. (Hoffman, 11/18)

The Washington Post: Top VA Official: Private Doctors Must Be ‘Part Of The Fabric Of VA Care’
A top Veterans Affairs official told lawmakers Wednesday that the government’s network of private doctors available to veterans at taxpayer expense is “too complicated” for veterans, physicians and VA employees. Deputy Secretary Sloan Gibson, laying out an ambitious plan to merge and expand VA’s private health-care system, said reforming what has become an inefficient, unwieldy bureaucracy is crucial to making outside care “part of the fabric of VA care” to meet a growing demand from veterans. (Rein, 11/18)

The Wall Street Journal: Clinton And Sanders Escalate Sniping On Health-Care Taxes
Democratic presidential contenders Hillary Clinton and Sen. Bernie Sanders for months have warily circled one another, contrasting their policy ideas in mostly gentle terms. No more. This week, Mrs. Clinton, the front-runner, unloaded on the Vermont senator, charging that Mr. Sanders would raise taxes on the middle class to pay for his single-payer health-care plan that would have the government replace private insurance companies to pay claims. (Meckler, 11/18)

The New York Times: Reviews Reveal Divisions Within The Clinton Health Initiative, Starting At The Top
Its chief executive, Ira C. Magaziner, who is admired as a brilliant, farsighted leader, has long alienated co-workers at the Clinton Foundation. But a harsh new set of complaints about Mr. Magaziner were captured this year in a performance review, with most of the grievances coming from the board of the Clinton Health Access Initiative, or CHAI, of which Chelsea Clinton is a member. The review said Mr. Magaziner had shown “disdain” for the health initiative’s board, exhibited “duplicitousness with management” and displayed a “lack of transparency” and “dismissive behavior” toward Clinton family members. (Haberman, 11/18)

The Wall Street Journal's Washington Wire: Club For Growth, Long An Establishment Gadfly, Takes Aim At Outsider Carly Fiorina
The conservative Club for Growth is casting doubt on another Republican presidential contender with less experience in elected office than many of her rivals. ... The group plans to release a research paper Thursday that questions Mrs. Fiorina’s commitment to the small-government, free-market policies the group advocates. The Club has raised similar doubts about businessman Donald Trump and retired neurosurgeon Ben Carson. The seven-page research document calls attention to Mrs. Fiorina’s past support for tax breaks for specific industries, inconsistent positions on spending issues, and general lack of specificity in how she would reform Medicare and Social Security. (O'Connor, 11/18)

The Associated Press: Kasich Aides Helped Craft Abortion Restrictions
Believing state legislators were solely responsible for abortion restrictions added to the 2013 budget bill, activists and editorialists across Ohio called on Gov. John Kasich to veto the provisions. What they didn't know at the time was that Kasich's office had a hand in developing some of the language. Among other things, the provisions required abortion clinics to have emergency-transfer agreements with hospitals, prevented public hospitals from joining those agreements and strengthened the state health director's authority to refuse exceptions. The combination contributed to clinic closures or near-closures in several cities. (11/18)

The Washington Post: American Medical Association Urges Ban On TV Drug Ads
If one of doctors’ largest lobbying groups has its way, the sun will soon set on the digitally-enhanced world of bright blue skies and fluffy clouds occupied by smiling patients in TV drug ads. The American Medical Association voted this week in favor of a ban on such direct-to-consumer (DTC) advertising of prescription drugs and medical devices. The resolution, approved by the AMA’s House of Delegates, has no immediate impact as only the Food and Drug Administration or Congress has the power to ban pharmaceutical advertising. (Moyer, 11/19)

The Associated Press: FDA Clears New, Easy-To-Use Version Of Heroin Antidote
The Food and Drug Administration has approved an easy-to-use version of the life-saving drug that reverses heroin and prescription painkiller overdoses, as communities across the country grapple with a wave of drug abuse. The reformulated drug, sold as Narcan, comes as a nasal spray and should help first responders, police and others deliver the antidote in emergency situations. Known generically as naloxone, the drug reverses the effects of opioids — drugs that include legal painkillers such as oxycodone and illegal narcotics such as heroin. (11/18)

The Washington Post: NIH Ends Era Of U.S. Medical Research On Chimpanzees
The National Institutes of Health has quietly ended the federal government’s long and controversial history of using chimpanzees for biomedical research. Director Francis Collins announced Wednesday that 50 chimpanzees held by the government for medical research will be sent to sanctuaries. His decision came a little more than two years after NIH decided to release more than 300 chimps at research facilities across the country and resettle them in more-humane conditions. (Fears, 11/18)

The Washington Post: Md. Agrees To Expand Medical Care At Baltimore City Detention Center
Maryland has agreed to expand medical care at the state-run Baltimore City Detention Center to settle a class-action lawsuit filed on behalf of pretrial detainees at the sprawling facility. The deal, announced Wednesday, requires the jail to provide accommodations for people with disabilities and to establish guidelines for assessing, treating and independently monitoring detainees’ physical and mental health. (Hicks, 11/18)

The Associated Press: State Of Maryland Settles Over Conditions In Baltimore Jail
The agreement says the state will overhaul its system for distributing medicine to inmates, as well as how detainees are screened and treated for mental illness. ... The case was settled in 1993 but was reopened in June after the plaintiffs argued that jail conditions were still so substandard it brings “shame to this city.” Inmates suffering from serious illnesses such as HIV and diabetes are being denied life-sustaining prescription medication and the state has failed to cure well-documented systemic problems within the jail after entering into a 2007 agreement with the U.S. Department of Justice, the court documents said. (Linderman, 11/18)

Los Angeles Times: Medi-Cal Cancer Patients Don't Fare Much Better Than The Uninsured, UC Davis Study Says
As part of a massive coverage expansion under the Affordable Care Act, millions of people have been allowed to sign up for California's health insurance plan for the poor for nearly two years. The program, known as Medi-Cal, now serves more than 12.5 million people, nearly 1 out of every 3 Californians. But there have been persistent concerns about the quality of care, with questions about whether patients can find doctors and get the help they need. (Karlamangla, 11/19)

NPR: In Tennessee, Giving Birth To A Drug-Dependent Baby Can Be A Crime
In the United States, a baby is born dependent on opiates every 30 minutes. In Tennessee, the rate is three times the national average. The drug withdrawal in newborns is called neonatal abstinence syndrome, or NAS, which can occur when women take opiates during their pregnancies. In the spring of 2014, Tennessee passed a controversial law that would allow the mothers of NAS babies to be charged with a crime the state calls "fetal assault." Alabama and Wisconsin have prosecuted new mothers under similar laws, and now other states are also considering legislation. (Shapiro, 11/18)

The Associated Press: Doctor Sentenced In New Jersey Lab Referral Scheme
A Long Island doctor has been sentenced to prison for his role in a bribery scheme involving a New Jersey lab. A federal judge in Newark sentenced Brett Halper of Glen Head, New York, to 46 months in prison Wednesday. The 41-year-old, who practiced in Rockville Centre, had pleaded guilty to accepting bribes. (11/18)

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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