First Edition: May 16, 2014

May 16 2014

Today's headlines include reports about the Indiana governor's alternative plan to expand Medicaid.

Kaiser Health News: Leaving Jail Doesn't Have To Mean Losing Health Care
Kaiser Health News staff writer Sarah Varney, working in collaboration with PBS Newshour, reports: "Men and women involved in the criminal justice system are more likely to be sicker than the general population, with higher rates of diabetes, hypertension, depression, mood disorders and alcohol and drug addiction. Many have spent years-;perhaps their entire adult lives-;without health insurance and have medical conditions that must be stabilized when they're incarcerated" (Varney, 5/15). Read this story, a related story by Varney, By The Numbers: Mental Illness Behind Bars, and watch the video.

Kaiser Health News: A Reader Asks: Will Using Electronic Cigarettes Affect My Insurance Rates?
Kaiser Health News' consumer columnist Michelle Andrews answers this readers question (5/16). Read her response.

Kaiser Health News: Capsules: Medicare Reverses Denial Of Costly Treatment For Hepatitis C Patient; Survey: Many Women Unaware How Health Law Benefits Them
Now on Kaiser Health News' blog, Richard Knox reports on a Medicare reversal for a Hepatitis C patient: "After Kaiser Health News and NPR described his plight in a story that aired Monday, federal Medicare officials said they would look into the case. Bianco's appeal of an earlier denial had been rejected by WellCare, a private insurer that contracts with the federal program to provide drug coverage. The insurer rejected coverage saying the combined use of the costly new drugs has not yet been approved by the Food and Drug Administration -; even though two doctors' groups had recommended the protocol in certain cases like Bianco's. Late Tuesday, Bianco's doctor got word that the earlier denials had been reversed – an unusually fast turnaround for the agency" (Knox, 5/15). 

Also on Capsules, Lisa Gillespie reports on a new survey about women and the health law: "A large number of women face significant barriers to health care, and while the health law will likely help them get services, some are unaware of the benefits already in effect, according to a new survey from the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.) Intended as a baseline to measure the future impact of the law, the findings identified several key issues" (5/15). Check out what else is on the blog.

The New York Times: Indiana Seeks More Coverage For Poor, But Many Would Pay
The governor of Indiana, Mike Pence, on Thursday proposed using federal Medicaid funds available under the Affordable Care Act to expand a state health insurance program to cover an additional 350,000 low-income adults. But unlike traditional Medicaid, the plan would require many participants to make monthly contributions toward the cost of coverage (Goodnough, 5/15).

The Wall Street Journal: Indiana Proposes Alternative To Medicaid
Indiana Gov. Mike Pence on Thursday said he wants to use Medicaid funding under the federal health-care law to expand coverage in his state, but that any expansion of it would have to come on his own terms. The proposal is the latest from a small group of mostly Republican governors pursuing alternative ways to tap billions of dollars in federal Medicaid money available under the Affordable Care Act. Most GOP governors are refusing the additional federal money outright, while those who have wanted to expand Medicaid faced objections from GOP-led legislatures (Peters and Radnofsky, 5/15).

Politico: Mike Pence Proposes Indiana Medicaid Expansion Plan
Indiana Gov. Mike Pence, whose rising national profile is feeding 2016 presidential buzz, has become the latest Republican governor to embrace a core component of Obamacare -; with a conservative twist. Pence, like Ohio Gov. John Kasich and New Jersey Gov. Chris Christie before him, announced a major push Thursday to expand Medicaid under the health care law and follow 26 states that have extended coverage to a larger share of their low-income residents (Cheney, 5/15).

The Washington Post's Wonkblog: Another Conservative Governor Finds Way To Expand Medicaid
It looks as if Indiana is about to join the list of red states signing up for Obamacare's Medicaid expansion.
Republican Gov. Mike Pence, after months of discussions with the Obama administration, is offering a new plan Thursday morning to expand coverage to low-income uninsured Hoosiers. As expected, he's doing it through an existing state insurance program for adults that's been championed by some conservatives (Millman, 5/15).

Politico: Romneycare Shadows Scott Brown's Anti-Obamacare Tour
Yet for all the vitriol, Brown may not be the purest critic. Obamacare is an offshoot of Romneycare, which Brown supported as a Republican state lawmaker in Massachusetts. That gives Brown the same problem Mitt Romney had while running for president in 2012: explaining why he likes and still defends a health reform law packed with mandates in Massachusetts while declaring its central elements unfit for the nation. Brown insisted in an interview that although Obamacare is "the biggest issue in New Hampshire" he is not taking health care cues from Romney (Cheney, 5/15).

Los Angeles Times: Obamacare Deadline Pushed To July 15 For Californians On COBRA
California's health exchange said an estimated 300,000 people in the state with COBRA insurance coverage can switch to an Obamacare policy through July 15. The Covered California exchange announced the special two-month enrollment period, starting Thursday, to address confusion about the sign-up rules (Terhune, 5/15).

The Associated Press: Cost-Control Plan For Health Care Could Cost You
The Obama administration has given the go-ahead for a new cost-control strategy called "reference pricing." It lets insurers and employers put a dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements. Some experts worry that patients could be surprised with big medical bills they must pay themselves, undercutting financial protections in the new health care law. That would happen if patients picked a more expensive hospital -; even if it's part of the insurer's network (5/16).

Los Angeles Times: Employer Health Costs To Rise Nearly 9% This Year, Study Finds
Employer healthcare costs are expected to rise nearly 9% in 2014, a slight improvement over recent years, according to a new survey. However, that modest decline doesn't offer much relief to companies and their employees, who are seeing health insurance costs take a bigger bite out of their paychecks (Terhune, 5/15).

Propublica/NPR: For Some Doctors, Almost All Medicare Patients Are Above Average
Office visits are the bread and butter of many physicians' practices. Medicare pays for more than 200 million of them a year, often to deal with routine problems like colds or high blood pressure. Most require relatively modest amounts of a doctor's time or medical know-how. Not so for Michigan obstetrician-gynecologist Obioma Agomuoh. He charged for the most complex -; and expensive -; office visits for virtually every one of his 201 Medicare patients in 2012, his billings show. In fact, Medicare paid Agomuoh for an average of eight such visits per patient that year, a staggering number compared with his peers (Ornstein and Grochowski Jones, 5/15).

The New York Times: U.S. Mines Personal Health Data To Find The Vulnerable In Emergencies
The phone calls were part Big Brother, part benevolent parent. When a rare ice storm threatened New Orleans in January, some residents heard from a city official who had gained access to their private medical information. Kidney dialysis patients were advised to seek early treatment because clinics would be closing. Others who rely on breathing machines at home were told how to find help if the power went out. Those warnings resulted from vast volumes of government data. For the first time, federal officials scoured Medicare health insurance claims to identify potentially vulnerable people and share their names with local public health authorities for outreach during emergencies and disaster drills (Fink, 5/15).

The Wall Street Journal: Allegations Over VA Wait Times Spur Rising Unease Among Democrats
Democrats showed increasing nervousness over the political peril raised by allegations of extended wait times at a Department of Veterans Affairs health facility, while the agency's acting inspector general said he had so far found no evidence patients had died because of long waits for care (McCain Nelson and Kesling, 5/15).

Politico: Eric Shineseki 'Mad As Hell' Over VA Scandal
Fighting for his political life, Veterans Affairs Secretary Eric Shinseki declared on Thursday he's "mad as hell" over allegations at the center of an unfolding scandal related to treatment delays at veterans hospitals. "If these allegations are true, they're completely unacceptable to me, to veterans," Shinseki told the Senate Veterans' Affairs Committee amid an effort to oust him over the issue (Herb and Wright, 5/15).

The Wall Street Journal: Gentiva Health Rejects Kindred's Takeover Bid
Gentiva Health Services Inc. confirmed Thursday that its board has rejected Kindred Healthcare Inc. 's $533 million takeover bid, saying the proposal significantly undervalues the company. Kindred made public the offer for the health and hospice company earlier Thursday, saying it had been rebuffed (Prior, 5/15).

The Wall Street Journal: Novartis Manages To Push Back Competition To Leukemia Drug In The U.S.
Swiss drug maker Novartis has managed to push back generic competition in the U.S. to its blockbuster leukemia drug Gleevec by about seven months, a deal that some critics say will deprive the public of the benefits of lower drug prices. Novartis declined to disclose the terms of the patent litigation settlement agreement it reached with generic drug maker Sun Pharmaceuticals Industries Ltd. But the company said that Sun Pharma's subsidiary won't be allowed to launch its own version of Gleevec in the U.S. until February 2016-;months after Gleevec's main U.S. patent, known as a basic compound patent, is scheduled to expire on July 4, 2015. The subsidiary of Mumbai-based Sun Pharma has tentative approval from the U.S. Food and Drug Administration for its generic version (Falconi, 5/15).

Los Angeles Times: Medical Malpractice Initiative Qualifies For November Ballot
What promises to be a hotly contested statewide voter initiative to raise the ceiling on medical malpractice judgments and require drug testing for physicians qualified Thursday for the November ballot. The measure pits insurance companies and medical providers against consumer advocates and trial lawyers, a clash expected to trigger a bitter, and extremely expensive, campaign (Mason, 5/15).

Los Angeles Times: Missouri Is Latest Battleground Over Abortion Rights, Restrictions
In the latest front in the battle over restrictions on abortion rights, it is now up to Missouri's governor to determine if the state will become the third to require that women wait three days after seeing a doctor before she can choose to terminate her pregnancy (Muskal, 5/15).

Los Angeles Times: Nevada GOP Gov. Brian Sandoval Is Popular, But Not Within His Party
But perhaps the greatest impediment to Sandoval's national advancement is his record since taking office in January 2011, which includes a broken promise to reduce taxes, support for legal abortion, embrace of the federal healthcare law and a decision to drop the state's legal fight against same-sex marriage -; all of which are anathema to the Republican base, even if they sit fine with many Nevadans (Barabak, 5/15).

The Associated Press: Missouri Backs Criminal Checks For Health Advisers
A bill given final approval by the Republican-led Legislature would require criminal background checks for people applying for state licenses to help consumers sign up for health insurance through a federally run website. Anyone with past convictions involving fraud or dishonesty would be barred from the jobs (5/15).