First Edition: July 22, 2013

Jul 22 2013

Today's headlines include reports about the continuing efforts in opposition to the health law as well as a Washington Post investigation into a "flaw" in U.S. health care pricing.

Kaiser Health News: Obamacare Delay Is A Relief For A Family Business
Kaiser Health News staff writer Jay Hancock, working in collaboration with The Philadelphia Inquirer, reports: "Like businesses across the country, Angelo's restaurant has been recovering from a miserable economy, a load of debt and a bottom line that until recently was the color of its special marinara sauce. So owner Michael Passalacqua probably speaks for many when he expresses relief about the decision to delay enforcing the Affordable Care Act's requirement for employer health insurance until 2015" (Hancock, 7/22). Read the story.

Kaiser Health News: Doctors Interested in MBAs Are Increasingly Looking For Traditional Business Programs, Not Health-Care Specific Degrees
Reporting for Kaiser Health News, in collaboration with The Boston Globe, Francine Russo writes: "When nervous dental patients make their first visit to Dr. Sree Koka, chair of dental specialties at the Mayo Clinic, they may feel calmer after watching his video on YouTube. It answers many of their questions: Is the doctor male or female? Does he speak English? Is he nice? In the video, Dr. Koka introduces himself, cracks a few jokes and suggests what patients should think about for their first appointment. He created the spot while attending MIT's Executive MBA program where he learned the benefits of focusing on personal relationships, not just technical expert" (Russo, 7/22). Read the story.

Kaiser Health News: Medicare Announces Plans To Accelerate Linking Doctor Pay To Quality
Kaiser Health News staff writer Jordan Rau, working in collaboration with The Washington Post, reports: "The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or penalties based on their performance by 2015, with all doctors who take Medicare patients phased into the program by 2017" (Rau, 7/22). Read the story.

Kaiser Health News: Consumers In Most States Unlikely To See N.Y.'s 50 Percent Reduction In Premiums In Individual Market
Kaiser Health News staff writer Julie Appleby reports: "New York's announcement this week that insurance premiums would drop 50 percent next year for individuals buying their own coverage in new online marketplaces made good talking points for proponents of the health law, but consumers in most states are unlikely to see similar savings" (Appleby, 7/19). Read the story.

Kaiser Health News: Analysis: N.Y. Insurance Market Called 'Poster Child' For Individual Mandate
Reporting for Kaiser Health News, Roni Caryn Rabin writes: "The nosedive in health insurance prices that New York officials announced earlier this week was driven by many factors, but the most important was the individual mandate, a central component of Obamacare. That's because insurers are betting they can use that often reviled requirement that takes effect Jan. 1 to nag, nudge, push and prod 2.6 million uninsured New Yorkers, especially the young and healthy, to buy coverage" (Rabin, 7/19). Read the story.

Kaiser Health News: Capsules: Humana Fills Blank Spots In Mississippi Obamacare Map
Now on Kaiser Health News' blog, Jay Hancock reports: "Filling a potential coverage void, Humana Inc. said Friday it will sell health insurance in 36 Mississippi counties that might have otherwise been left out of a marketplace for subsidized policies sold under the Affordable Care Act" (Hancock, 7/19). Check out what else is on the blog.

The Hill: Obama Tries To Regain ObamaCare Edge After Mandate Delay Setback
The standard line from Obama and his allies was that the law had been passed by Congress, signed by the president, upheld by the Supreme Court, and then affirmed again by Obama's reelection. But the decision to delay the employer mandate cut against that narrative of inevitability, allowing Republicans to argue that the law is collapsing on its own -; and creating a double standard that rewarded business at the expense of individuals and families (Baker, 7/21).

The Associated Press: After 3 years, House Republicans Still Voting To Repeal 'Obamacare,' But Have No Replacement
Three years after campaigning on a vow to "repeal and replace" President Barack Obama's health care law, House Republicans have yet to advance an alternative for the system they have voted more than three dozen times to abolish in whole or in part. Officially, the effort is "in progress" -; and has been since Jan. 19, 2011, according to GOP.gov, a leadership-run website. But internal divisions, disagreement about political tactics and Obama's 2012 re-election add up to uncertainty over whether Republicans will vote on a plan of their own before the 2014 elections (Espo, 7/21).

The Hill: Boehner: GOP Will Do 'Everything We Can' To Thwart ObamaCare
"ObamaCare is bad for America," Boehner told CBS's "Face the Nation." "We're going to do everything we can to make sure it never happens." Boehner's comments come several days after the House voted to delay the law's employer and individual mandates over a White House veto threat (Viebeck, 7/20).

The Wall Street Journal's Washington Wire: Union Fears 'Destructive Consequences' From Obamacare
The laborers union has added to organized labor's drumbeat of dissatisfaction with the Affordable Care Act. In a letter sent to President Barack  Obama on Thursday, Laborers International Union of North America President Terry O'Sullivan wrote that the law has "destructive consequences" for the types of health plans that cover millions of unionized construction workers and their family members (Maher, 7/19).

The New York Times: Republicans In Arizona Are At Odds On Medicaid
For Gov. Jan Brewer, the passage last month of a Medicaid expansion was a major coup. Despite a Republican majority in the Legislature, where she faced significant opposition from Tea Party members, she rallied the entire Democratic delegation to her side and made a progressive issue palatable to just enough conservatives, casting the expansion as the right decision for the state, morally and monetarily (Santos, 7/21).

The Washington Post: Indiana Says Health Plan Costs Will Spike To $570. That's Not The Full Story
The average health insurance plan in Indiana will increase by 72 to percent next year and hit $570 under the 2010 health-care law, the state announced Friday. What does that tell us? It certainly doesn't tell us insurance coverage in Indiana will be cheap; that much is obvious. But it doesn't really tell us that Indiana's premiums are outrageous – in fact, when you dig into the documents insurers' filed, it turns out Indiana's rates look a lot like the rest of the country (Kliff, 7/20).

The Washington Post: Obamacare Already Working In D.C., Officials Say
With less than three months until its go-live date, District officials say the city's health insurance exchange is already functioning as planned by one important measure: prices. City insurance regulators announced Friday that they have finishing granting approval to the plans set to be offered on the exchange, known as D.C. Health Link, starting Oct. 1. Four insurers are offering 301 different plans, and three of the four lowered their prices from their initial proposals after learning what their competitors were planning to charge (DeBonis, 7/19).

The Los Angeles Times: Healthcare Overhaul Leads Hospitals To Focus On Patient Satisfaction
For years, the check-in process in the urgent care center of this city's large, downtown hospital was reminiscent of a visit to the DMV. The ailing and sick walked in, pulled a number, took a seat and waited to be called. Many grew impatient and exasperated. Now, patients at San Francisco General Hospital are greeted by a smiling face and a helping hand to guide them along the path to getting care. It's one of a series of customer-friendly touches being added at the 156-year-old institution by a newly named "chief patient experience officer." ... Under the national healthcare overhaul, patient experiences matter. Federal payments are being tied to surveys that gauge patient attitudes about such things as a hospital's noise and cleanliness, communication and pain management (Gorman, 7/20).

The Los Angeles Times: National Healthcare Reform Sparks Concern About Scams
The national health reform law is expected to open the door for identity theft and insurance scams when millions of uninsured Americans begin enrolling in coverage this fall, officials and advocates warn. The Federal Trade Commission said dozens of consumers have reported fraud since last summer's Supreme Court ruling upholding the law, and officials predict widespread abuse when enrollment begins in October (Gorman, 7/20).

The Wall Street Journal: Student Health Plans Boost Coverage And Price
Student health-insurance plans are getting better-;and pricier. Under the Affordable Care Act, the minimum annual benefits limit of such plans will jump to $500,000 for the 2013-14 school year, up from $100,000 in 2012-13. And the cap will disappear for the 2014-15 school year. Also starting next year, student plans can't exempt pre-existing conditions and will be expected to cover the same 10 essential benefits as other individual health plans, including prescription drugs, preventative services and mental-health care. But the plans cost more, too (Blumenthal, 7/21).

The Washington Post: How A Secretive Panel Uses Data That Distorts Doctors' Pay
Twelve colonoscopies and four other procedures was a typical day for [physician Harinath Sheela], according to Florida records for 2012. If the American Medical Association's assumptions about procedure times are correct, that much work would take about 26 hours. Sheela's typical day was nine or 10. ... "I have experience," the Yale-trained, Orlando-based doctor said. "I'm not that slow; I'm not fast. I'm thorough." This seemingly miraculous proficiency, which yields good pay for doctors who perform colonoscopies, reveals one of the fundamental flaws in the pricing of U.S. health care, a Washington Post investigation has found (Whoriskey and Keating, 7/20).

Politico: The 'Death Panel' Bill Lives
The bill is back. Or rather, it's never gone away.Each Congress, Blumenauer reintroduces it. He's even added a few new elements, for instance to make sure that care preferences are incorporated into electronic medical records, not just stuffed in someone's bedside table. He's picked up 15 co-sponsors, including a few Republicans. Among them is Tennessee Rep. Phil Roe, an outspoken member of the conservative House GOP Doctors Caucus, which helps drive an unwavering opposition to Obamacare (Kenen, 7/21).

Los Angeles Times: Anthem Blue Cross Shuns Insurance Market For Small Businesses
Health insurance giant Anthem Blue Cross is spurning California's new insurance market for small businesses, a potential setback in the state's rollout of the federal healthcare law. Anthem, a unit of WellPoint Inc., is California's largest insurer for small employers. The company's surprising move raised concerns about the state's ability to offer competitive rates and attract businesses to its new Covered California exchange that opens Jan. 1 (Terhune, 7/19).

The New York Times: Cries Of Betrayal As Detroit Plans To Cut Pensions
Gloria Killebrew, 73, worked for the City of Detroit for 22 years and now spends her days caring for her husband, J. D., who has had three heart attacks and multiple kidney operations, the last of which left him needing dialysis three times a week at the Henry Ford Medical Center in Dearborn, Mich. Now there is a new worry: Detroit wants to cut the pensions it pays retirees like Ms. Killebrew, who now receives about $1,900 a month (Yaccino and Cooper, 7/21).

The Washington Post: After Detroit Bankruptcy Filing, City Retirees On Edge As They Face Pension Cuts
The battle over the future of Detroit is set to begin this week in federal court, where government leaders will square off against retirees in a colossal debate over what the city owes to a prior generation of residents as it tries to rebuild for the next. … Orr has promised that retired city workers, police officers and firefighters will not see pensions or health benefits reduced for at least six months. But on Sunday, he said those retirement benefits will have to be cut down the road (Goldfarb, 7/21).

The Associated Press/Washington Post: Delaware Governor Signs Bill Capping Co-Pays For Specialty Prescription Drugs
Gov. Jack Markell is signing legislation that caps co-pays for prescription drugs used to treat certain complex and chronic health problems. The legislation to be signed Monday limits patients' co-insurance or co-payment fees for certain prescription drugs to $150 per month for up to a 30-day supply (7/22).

Los Angeles Times: Health Centers Vary Widely In Quality Of Medical Management
California's community health centers -; a key resource for people without medical insurance -; vary widely in their ability to control their patients' chronic diseases, including diabetes and high blood pressure, according to federal data (Gorman, 7/21).

The Washington Post: Cuccinelli, McAuliffe Spar At Va. Gubernatorial Debate
After months of assailing each other's integrity from afar and by proxy, Attorney General Ken Cuccinelli II and businessman Terry McAuliffe traded direct attacks on stage Saturday in the opening debate of their heated race for Virginia governor. ... Cuccinelli reiterated his opposition to President Obama's health-care plan, but he also criticized Obama for not following his own law by postponing the legislation's employer mandate for one year. McAuliffe, meanwhile, made clear that he still supports the law and stressed that he thinks Virginia should accept the measure's invitation to expand the state's Medicaid program, which Cuccinelli opposes (Pershing and Vozzella, 7/20).

The New York Times: Legal Battles Continue As Hospital In Brooklyn Nears Closing Date
As Long Island College Hospital in Brooklyn edged closer to shutting its emergency room and transferring its few remaining patients to other hospitals, those who want to close the hospital and those fighting to keep it open skirmished over the weekend in a flurry of legal maneuvers and bitter accusations (Yee and Vadukul, 7/21).

Los Angeles Times: 16 Medi-Cal Substance Abuse Treatment Centers Are Under Investigation
Sixteen drug and alcohol treatment centers that provide rehabilitative services to Medi-Cal patients are suspected of fraud and of hiring providers with felonies on their records, officials from the California Department of Health Care Services announced this week (Kumeh, 7/19).

NPR: State Abortion Laws Differ From Doctors In Defining 20 Weeks
Texas last week became the 12th state to ban most abortions after 20 weeks. But most of the state laws don't define 20 weeks the same way doctors do (Rovner, 7/22).