First Edition: July 28, 2014

Jul 28 2014

Today's headlines include reports about the deal reached by House and Senate negotiators regarding veterans' health care.

Kaiser Health News: Limitations Of New Health Plans Rankle Some Enrollees
Kaiser Health News staff writer Julie Appleby reports: "Nancy Pippenger and Marcia Perez live 2,000 miles apart but have the same complaint: Doctors who treated them last year won't take their insurance now, even though they haven't changed insurers. … In Plymouth, Ind., Pippenger got similar news from her longtime orthopedic surgeon, so she shelled out $300 from her own pocket to see him. Both women unwittingly bought policies with limited networks of doctors and hospitals that provide little or no payment for care outside those networks. Such plans existed before the health law, but they've triggered a backlash as millions start to use the coverage they signed up for this year through the new federal and state marketplaces. The policies' limitations have come as a surprise to some enrollees used to broader job-based coverage or to plans they held before the law took effect" (Appleby, 7/28). Read the story, which also ran in USA Today.

The Wall Street Journal: States Try To Protect Health Exchanges From Court Ruling
A number of states are scrambling to show that they-;not the federal government-;are or will soon be operating their insurance exchanges under the 2010 health law, in light of two court decisions this week. The efforts are aimed at ensuring that millions of consumers who get insurance through the exchanges would be able to retain their federal tax credits if courts ultimately rule against the Obama administration (Radnofsky, 7/25).

Politico: States Want More Time On ACA Funds
States running their own Obamacare exchanges were supposed to wean themselves off federal funding by the end of this year, but some of them want that Obama administration spigot open a bit longer. The states aren't asking for the feds to dole out more money on top of the $4.6 billion already dedicated to exchange planning and construction. But they do want to be able to spend their federal exchange grants into 2015 as they grapple with core components of the insurance portals that are balky, unfinished or in disrepair (Cheney and Wheaton, 7/25).

The Associated Press: Plan To Simplify 2015 Health Renewals May Backfire
If you have health insurance on your job, you probably don't give much thought to each year's renewal. But make the same assumption in one of the new health law plans, and it could lead to costly surprises. Insurance exchange customers who opt for convenience by automatically renewing their coverage for 2015 are likely to receive dated and inaccurate financial aid amounts from the government, say industry officials, advocates and other experts (7/27).

The Wall Street Journal: Health-Law Patients Boost Hospital Profits
A wave of newly insured patients helped boost hospitals' earnings in recent months, two hospital operators said Friday, a sign the law's coverage expansion is leading more patients to seek treatment. Universal Health Services Inc. UHS 's revenue rose 10% for the second quarter compared with a year earlier. LifePoint Hospitals Inc.'s profit rose to $39.1 million for the quarter, a 44% increase compared with last year's quarter. Those results arrive on the heels of HCA Holdings Inc. HCA's announcement of strong earnings last week ahead of its July 29 earnings call (Weaver,7/25).

The Wall Street Journal: Universal Health Services Profit Down On Higher Operating Charges
"The reduction in uncompensated care at our acute care hospitals resulting both from healthcare reform and improvements in the underlying economy partially reverses a trend that had been hindering our results for an extended period of time," said Alan B. Miller, the company's chief executive (Armental, 7/24).

The Wall Street Journal's Washington Wire: Health Law Architect's Taped Remarks Fuel Subsidy Debate
Backers of the latest legal challenges to the Affordable Care Act are seizing on comments made in 2012 by an MIT economist, often referred to as the law's architect, to support their argument that only people who buy health coverage through a state exchange – not exchanges run by the federal government–can get tax credits towards the cost of premiums (Radnofsky and Kendall, 7/25).

Politico: An Obamacare Gotcha Moment
One of Obamacare's chief architects, MIT professor Jonathan Gruber, just handed conservatives a gotcha moment. Health law opponents and conservative academics are highlighting a two-year-old video of Gruber -; who has advised both the Obama administration and then-Gov. Mitt Romney's Massachusetts health reform effort -; in which he seems to agree that the law's health insurance subsidies can't be awarded through federal-run exchanges, only through the state-run markets (Winfield Cunningham, 7/25).

The Washington Post's Wonkblog: Q&A: The New $84,000 Hepatitis C Drug
Is $84,000 the final price of Sovaldi? Not necessarily. Insurers have been trying to negotiate with the manufacturer, and U.S. government health programs receive a 23 percent discount. Sovaldi is cheaper in countries where the government sets drug prices, ranging from $900 in Egypt to $66,000 in Germany. And for some patients, Sovaldi has been paired with Johnson and Johnson's Olysio, another new hepatitis C drug priced at $66,000 in the United States (Millman, 7/25).

The Wall Street Journal: House Tells Court It Can Lawfully Ignore SEC Requests For Records
The U.S. House of Representatives told a federal court Friday it should dismiss a lawsuit filed by the Securities and Exchange Commission because Congress is lawfully allowed to ignore requests to turn over records and testimony to the executive branch agency. "Rather than acknowledge the fool's errand on which it has embarked, the SEC instead invites this court to join it by disregarding fundamental limitations on judicial authority," wrote House attorneys in a new court filing (Ackerman and Mullins, 7/25).

The Wall Street Journal: Congress Set To Leave A Full Plate
Congress loves a deadline. But this year, even that may not be enough. With just a week left before the start of a five-week August recess, it is increasingly likely that Congress will wrap up for the summer having cobbled together only the bare minimum to keep the government functioning without addressing a list of expiring laws and a pileup of potential national crises. … The two chambers, for example, haven't figured out how to respond to the surge of Central American families crossing the southern border. Lawmakers also had struggled over a bill aimed at mitigating mismanagement and long wait times at Veterans Affairs hospitals, though spokesmen for the top negotiators said Sunday that a deal had been reached (Peterson, 7/27).

Politico: Deal Reached On VA Reforms
Sen. Bernie Sanders and Rep. Jeff Miller have reached an agreement to reform the Department of Veterans Affairs, according to an aide briefed on the matter. The legislation, which is to be unveiled Monday, will touch on "both the short-term and long-term needs of the VA," the aide said (French, 7/27).

The Associated Press: With Deadline Looming, Lawmakers Reach Deal On VA Health Care
The chairmen of the House and Senate Veterans Affairs committees have scheduled a news conference Monday afternoon to unveil a plan expected to authorize billions in emergency spending to lease 27 new clinics, hire more doctors and nurses and make it easier for veterans who can't get prompt appointments with VA doctors to obtain outside care (7/28).

The Washington Post: House, Senator Negotiators Reach Deal On Veterans Bill 
Aides said that Sanders and Miller had worked out final language on the agreement, which would be circulated among lawmakers on Monday ahead of the formal announcement. One House aide, not authorized to speak publicly about the talks, said that the final agreement more closely mirrors a Senate measure overwhelmingly approved by Democrats and Republicans last month (O'Keefe, 7/27).

The Washington Post's Federal Eye: The New VA-Reform Deal, And How The Costs Shrank Over Time
After a weekend of talks, House and Senate negotiators say they have reached a deal to help the troubled Department of Veterans Affairs address extensive wait times at VA medical centers, one of the root causes of the agency's recent scheduling scandal. Lawmakers now have about five working days to recommend changes and vote on the agreement before Congress begins its August recess. Sen. Bernie Sanders (I-Vt.) and Rep. Jeff Miller (R-Fla.), who lead the Senate and House veterans affairs committees, respectively, will try to round up support for sending the measure to President Obama before then (Hicks, 7/28).

The New York Times: Lawmakers Reach Deal On A Fix for V.A.'s Health Care System
House and Senate negotiators reached agreement during the weekend on a legislative package intended to stabilize the Department of Veterans Affairs' sprawling and embattled health care system, according to people briefed on the deal (Oppel Jr., 7/27).

Los Angeles Times: VA Healthcare: Tentative Deal Reached In Congress
Congressional negotiators have reached a tentative agreement on legislation to bolster healthcare funding and reforms at the troubled Department of Veterans Affairs, salvaging a deal after talks imploded last week. The accord comes none too soon: Lawmakers are poised to leave town at the end of the week for the long August break. A stalemate could politically damage the already unpopular Congress (Mascaro, 7/27).

The Wall Street Journal: Congress Reaches Deal To Help Fix VA
Leaders from the House and Senate Committees on Veterans' Affairs announced Sunday they have reached a deal on legislation to help fix the VA that has been bogged down in conference committee for more than a week over partisan bickering and questions of costs (Kesling, 7/27).

The New York Times: In Politics, The 'Virginia Way' No Longer Reflects Its Genial Southern Roots
The polarization of Richmond mirrors Washington, part of a nationalization of politics in state capitals with divided government across the country. The Legislative session that recently ended featured teeth-spitting acrimony between Gov. Terry McAuliffe, a Democrat, and Republicans in the General Assembly, which nearly led to a government shutdown. … The issue that nearly ground government to a halt was expanding Medicaid under President Obama's health care law. Mr. McAuliffe, the most liberal Virginia governor of modern times, favored it. The Republican-led Legislature, influenced by its Tea Party wing, strongly opposed it, even though many of the working poor who would have gained health insurance under the Affordable Care Act were from rural districts represented by Republicans (Gabriel, 7/27).

The Washington Post: Ralph Northam, Va.'s Low-Key Lieutenant Governor, Juggles Politics And Pediatrics
Ralph S. Northam read Noah's electroencephalogram and sent the 7-year-old home from the hospital with a dose of powerful anti-seizure medication and instructions to return for more tests. Northam's work as a doctor is a far cry from his other day job, presiding over the Virginia Senate, where he welcomes visitors to Mr. Jefferson's Capitol and enforces the chamber's arcane rules. Most Virginians don't know that the lieutenant governor spends much of his time treating sick children as a pediatric neurologist. More to the point, most Virginians don't know who the lieutenant governor is (Portnoy, 7/27).

NPR: New York Debates Whether Housing Counts As Health Care
Brenda Rosen, the director of Common Ground, the organization that manages the building, says The Brook offers a full range of services to keep its residents healthy: social workers, security, a doctor and even an event planner. And while these services don't come without a cost -; an apartment at The Brook runs at about $24,000 a year -; Rosen says they are cheaper than the estimated $56,000 per year that the city spends on the emergency room visits, and stays at shelters and jails, where many people with severe mental illness end up (Aronczyk, 7/28).

The Associated Press: Relatives Run Health Clinic In Madison
Dr. Schenck received his doctorate in 1978 and finished his residency in 1981. He briefly latched on with a practice in Orange before coming to Culpeper to practice, where he was tasked with opening the Culpeper Nursing Home and Rehab. He also set up and ran his practice at the Wilderness Medical Center in Locust Grove from 1982 until 2002. A hospitalist at Culpeper Regional Hospital from 2002 until 2006, he and his wife Lisa -; his registered nurse -; both moved to the Madison practice in 2008 (7/27).