First Edition: May 13, 2013

May 13 2013

Today's headlines include reports that Health and Human Services Secretary Kathleen Sebelius has been seeking out funds from private sources to support efforts to publicize the health law. 

Kaiser Health News: Under-26 Coverage: Does It Matter If My Child Just Got Out Of Jail? (Video)
Kaiser Health News consumer columnist Michelle Andrews answers a reader question about keeping your children on your health plan until they turn 26, even if they were recently released from jail (5/13). Watch the video or read the transcript.

Kaiser Health News: Obama: 'The Law Is Here To Stay' (Video)
Kaiser Health News has a video from President Barack Obama gave Friday speech on the health law, in which he emphasized his administration's commitment to moving forward with a full rollout of all the law's provisions (5/10). Watch the video or read the transcript. KHN also tracked news coverage of the speech (5/10).

Kaiser Health News: Oregon's Medicaid Lottery: A Participant's View
Kaiser Health News staff writer Jordan Rau, working in collaboration with The Washington Post, reports: "After winning the lottery, Mary Carson, 55, was accepted into the Oregon Health Plan, the state's Medicaid program, in 2011. She and her partner live with her three children. They earn about $1,000 a month by making and selling replicas of historic battle knives used in the Civil War and the two World Wars, doing odd jobs and providing respite care for people with cancer. Her comments on a popular blog about some of her own experiences on Medicaid have garnered some attention" (Rau, 5/10). Read the interview.

Kaiser Health News: Capsules: What A Hospital Charges Vs. What Medicare Pays; Competition Spurs Ore. Insurers To Lower Proposed Rates
Now on Kaiser Health News' blog, Alaska Public Radio's Annie Feidt, working in partnership with KHN and NPR, offers this report on hospital charges: "For the first time, the federal government has publicly shared what hospitals bill Medicare for the 100 most common diagnoses and treatments. The information shows hospitals across the country -; and across Alaska -; bill dramatically different prices for the same things" (Feidt, 5/13).

Also on the blog, Phil Galewitz reports on competition between insurers in Oregon: "Maybe competition among health insurance plans can lead to lower rates. As soon as Oregon this week became the fourth state to publicly list health insurers' proposed 2014 rates for individual and small group coverage, two plans moved to cut their suggested prices, the Oregonian reported Friday. Providence Health Plan and Family Care Health Plans sought to lower their rates when they noticed they were out of whack compared to competitors -; five months before the health law's new online marketplaces even open for enrollment" (Galewitz, 5/10). Check out what else is on the blog.

The New York Times: Cabinet Secretary Solicits Large Donations To Publicize Health Care Law
Kathleen Sebelius, the secretary of health and human services, has solicited sizable donations from the Robert Wood Johnson Foundation and H&R Block, the tax preparation service, as part of a multimillion-dollar campaign to ensure the success of President Obama's health care law, administration officials said Sunday, even as a leading Senate Republican raised questions about the legality of her efforts. The foundation is expected to contribute as much as $10 million, while H&R Block is expected to make a smaller donation of about $500,000, the officials said (Pear, 5/12).

The Washington Post: Budget Request Denied, Sebelius Turns To Health Executives To Finance Obamacare
Health and Human Services Secretary Kathleen Sebelius has gone, hat in hand, to health industry officials, asking them to make large financial donations to help with the effort to implement President Obama's landmark health-care law, two people familiar with the outreach said. Her unusual fundraising push comes after Congress repeatedly rejected the Obama administration's requests for additional funds to set up the Affordable Care Act, leaving HHS to implement the president's signature legislative accomplishment on what officials have described as a shoestring budget (Kliff, 5/10).

The Wall Street Journal: Sebelius Sought Industry Funds For Health Law
Because of the way the health law was written, Washington ended up with few resources to try to sign up uninsured people in the 33 states that refused to run their own insurance exchanges. The Obama administration has said before that it wants to try to make up for HHS' limited funding for public outreach work by tapping outside help (Radnofsky, 5/10).

The Associated Press/Washington Post: Senator Takes Issue With Fundraising Pitches By Health And Human Services Secretary
The administration has recently announced it would be directing $200 million to states, private groups and local health centers so that they can hire workers who can help consumers pick the insurance plan best for them. The fundraising pitches appear to be another step along those lines. Beginning Oct. 1, people can start signing up for coverage through new state and federal health exchanges. But Sen. Orrin Hatch, R-Utah, said that soliciting money from health care executives is absurd. "Moving forward, I will be seeking more information from the administration about these actions to help better understand whether there are conflicts of interest and if it violated federal law," Hatch said (5/10).

The Associated Press/Washington Post: Cancer Patients And Others Taking Pricey Drugs Could Pay Thousands In Health Overhaul Plans
Cancer patients could face high costs for medications under President Barack Obama's health care law, industry analysts and advocates warn. Where you live could make a huge difference in what you'll pay (5/13).

The Washington Post: Health Insurance Tax 'Scares The Daylights' Out Of Some Small-Business Owners
Many small-business owners worry that a new tax on insurance providers in the health-care law will mean higher premiums for them, undermining the law's capacity to lower their health-care costs. Starting next year, the federal government will charge a new fee on health insurance firms based on the plans they sell to individuals and companies, known as the fully insured market (Harrison, 5/12).

Los Angeles Times: Healthcare Puts Jerry Brown, Capitol Democrats On Different Sides
With California's deficit wiped out and its economy starting to hum, this was to be a year when Gov. Jerry Brown was free of the budget logjams that have paralyzed the Capitol. But instead, the governor has a fight on his hands -; with his fellow Democrats. He is on a collision course with them over how to reshape the state's sprawling, complicated healthcare system to conform with President Obama's national overhaul (York and Megerian, 5/10).

Politico: White House Gives Nod To Utah's Dual Exchange
Utah will be the only state in the country next year to run its own Small Business Health Options Program exchange -; under a modified set of Obamacare rules -; and let the federal government set up the exchange for the individual market. Republican Gov. Gary Herbert announced Friday that Utah had received a crucial nod from the White House that will allow the state to bend Obamacare's exchange rules to accommodate the state's small-business exchange (Cheney, 5/13).

The Associated Press/Washington Post: Feds Approve Utah To Become First State To Use Dual-Model Health Insurance Marketplace
The federal government has approved Utah to become the first state to have a dual-model health insurance exchange in which the state and the federal government divide responsibilities. The plan allows Utah to continue to run its existing health insurance marketplace for small businesses, a system that lets employees pick health care plans in an online exchange. The federal government will run the state's individual exchange. The two marketplaces will operate independently of each other (5/10).

ProPublica/The Washington Post: Dangers Found In Lack Of Safety Oversight For Medicare Drug Benefit
An analysis of four years of Medicare prescription records shows that some doctors and other health professionals across the country prescribe large quantities of drugs that are potentially harmful, disorienting or addictive for their patients. Federal officials have done little to detect or deter these hazardous prescribing patterns (Weber, Ornstein and LaFleur, 5/11).

The New York Times: Hospital Mergers Reset Abortion-Access Battle
Politicians seeking to restrict access to abortion, a marked trend this year from North Dakota to Arkansas, tend not to get much traction in this part of the country. Washington is heavily Democratic, leaning left especially on social issues. A majority of voters even put into law a statutory right to abortion in 1970 -; the only state ever to do that. The governor, Jay Inslee, a Democrat, is pushing the Legislature even now to pass a law at a special session on Monday requiring health insurers to pay for elective abortions, another first for the state if it makes it to Mr. Inslee's desk (Johnson, 5/12).

The New York Times: Judge Refuses To Drop His Order Allowing Morning-After Pill For All Ages
A federal judge on Friday stepped up his criticism of the Obama administration, accusing the Justice Department of making "frivolous" and "silly" arguments in its attempt to delay making the morning-after emergency contraceptive pill available to women and girls of all ages without a prescription (Shear, 5/10).

Los Angeles Times: Judge Again Rejects Limits On Emergency Contraception
In yet another scathing critique of government health officials, a federal judge refused Friday to stay his order making emergency contraceptives available to consumers of all ages without a prescription. Calling government efforts to restrict the sale of drugs such as Plan B "frivolous and taken for the purpose of delay," U.S. District Judge Edward R. Korman of New York wrote that the medications would be available to all unless the 2nd Circuit Court of Appeals ruled otherwise by noon Eastern time on Monday (Morin, 5/11).

Los Angeles Times: Vietnam Veterans' New Battle: Getting Disability Compensation
Otte is among hundreds of thousands of veterans from the Vietnam era filing for damages four decades after the war. They account for the largest share of the 865,000 veterans stuck in a growing and widely denounced backlog of compensation claims -; some 37%. The post 9-11 wars in Afghanistan and Iraq account for 20%. The remainder are from the 1991 Gulf War, Korea, World War II and times of peace. Basic demographics explain some of the filing frenzy. Vietnam veterans are becoming senior citizens and more prone to health problems. Any condition they can link to their military service could qualify for monthly payments -; and for many illnesses, it is easier for Vietnam veterans than other former troops to establish those links (Zarembo, 5/11).

The Associated Press: Ginsburg Says Roe Gave Abortion Opponents Target
One of the most liberal members of the U.S. Supreme Court, Justice Ruth Bader Ginsburg could be expected to give a rousing defense of Roe v. Wade in reflecting on the landmark vote 40 years after it established a nationwide right to abortion. Instead, Ginsburg told an audience Saturday at the University of Chicago Law School that while she supports a woman's right to choose, she feels the ruling by her predecessors on the court was too sweeping and gave abortion opponents a symbol to target. Ever since, she said, the momentum has been on the other side, with anger over Roe fueling a state-by-state campaign that has placed more restrictions on abortion (Keyser, 5/11).

The New York Times: Seeking Clues To Heart Disease In DNA Of An Unlucky Family
Researchers have long known that a family history of early death from heart disease doubles a person's risk independently of any other factors. Family history is defined as having a father or a brother who were given a diagnosis of heart disease before age 55 or a mother or sister before age 65. Scientists are studying the genetic makeup of each member of the Del Sontro family, searching for telltale mutations or aberrations in the long sequence of three billion chemicals that make up human DNA. Until very recently, such a project almost certainly would have been futile. Picking through DNA for tiny aberrations was so costly and time-consuming that it was impractical to take on for an entire family (Kolata, 5/12).

Los Angeles Times: Patient Is Out Of Network, Out Of Luck
A worrisome abdominal pain drove Jalal Afshar to seek treatment last year at healthcare giant Kaiser Permanente. ... Kaiser granted his request to see a specialist in Arkansas. But it ultimately declined to pay for his treatment there. By June, Afshar said, Kaiser was arranging for hospice care so that he could die at home. Afshar, 58, refused to accept that. Despite Kaiser's stance, he went back to Arkansas for six months of stem-cell transplants, chemotherapy and other treatments that he says saved his life. Now he owes $2 million for his care and is suing the company in state court for breach of contract and unfair business practices (Terhune, 5/10).

The New York Times: City Plans New Approach To Disciplining Mentally Ill Inmates
New York City will soon change the way mentally ill inmates are disciplined after breaking rules while in jail, creating alternatives to the more traditional approach of solitary confinement used for most inmates (Yee, 5/12).

The Associated Press/Washington Post: Tenn. Hospital On Front Lines Of US Pill Epidemic, Treating Babies Born Dependent On Drugs
He's less than two weeks old, but he shows the telltale signs of a baby agitated and in pain: an open sore on his chin where he's rubbed the skin raw, along with a scratch on his left check. He suffers from so many tremors that he's been placed in a special area so nurses can watch him around the clock in case he starts seizing -;or worse, stops breathing (5/12).