First Edition: September 4, 2014

Today's headlines include reports about a new government report that predicts a rebound in national health spending.

Kaiser Health News: Health Care Spending Forecast To Increase Modestly In Next Decade
Kaiser Health News staff writer Mary Agnes Carey reports: "National health spending will increase modestly over the next decade, propelled in part by the gradual rebound of the U.S. economy and the growing ranks of Americans who became insured under the health law, government actuaries projected Wednesday. But those growth rates are not as high as what the country saw for the two decades before the Great Recession crippled the U.S. economy at the end of 2007, according to the report from the Centers for Medicare & Medicaid Services Office of the Actuary and published in the journal Health Affairs"(Carey, 9/3). Read the story.

Kaiser Health News: Maine Rolls Back Health Coverage Even As Many States Expand It
Reporting for Kaiser Health News, Roni Caryn Rabin writes: "Maine Gov. Paul LePage's decision to shrink Medicaid instead of expanding it was a radical departure from a decade-long effort to cover more people in this small rural state of farmers, lobstermen, craftsmen and other seasonal workers, which at least until recently, boasted one of the lowest rates of uninsured in the nation. Maine was the only state ¬in New England, and one of 21 nationally, to decline federal money to expand Medicaid under the federal law. In most of those states, Republican lawmakers or executives argued that Congress could withdraw the health law's funding and that their states couldn't afford the expense. Many also objected to expanding a program they regard as broken" (Rabin, 9/4). Read the story, which also ran in USA Today.

The New York Times: After Slow Growth, Experts Say, Health Spending Is Expected To Climb
Government experts on Wednesday predicted a rebound in national health care spending as expansions in coverage and improvements in the economy take hold after four years of exceptionally slow growth in the nation's medical bills (Pear, 9/3).

Los Angeles Times: Nation's Healthcare Changes May Rein In Costs In Long Run, Report Says
The report released Wednesday suggests that changes underway in medical care and insurance coverage may help rein in America's notoriously high-cost system, even as millions of Americans gain insurance through the federal healthcare law. But the slowing still may not make healthcare affordable, as medical spending is projected to outpace economic growth over the next decade, the report says (Levey, 9/3).

The Wall Street Journal: Health Spending Grew 3.6% In 2013, Projections Show
The growth of U.S. health spending remained at historic lows in 2013, but it is projected to accelerate with a rebounding economy and expanded insurance coverage under the Affordable Care Act, new federal figures show. National health-care spending is projected to have increased 3.6% to $2.89 trillion in 2013, according to a forecast released Wednesday by the Centers for Medicare and Medicaid Services. Actual figures haven't yet been calculated for that year. The growth figure would mark the fifth consecutive year of spending increases under 4% and is among the lowest rates since the government began tracking the gains in the 1960s. By comparison, rate of increase in the gross domestic product was 3.4% in 2013, according to the CMS report (Armour, 9/3).

The Washington Post's Wonkblog: The End Of Health Care's Historic Spending Slowdown Is Near
As the economy recovers, Obamacare expands coverage and baby boomers join Medicare in droves, the federal Centers for Medicare and Medicaid Services' actuary now projects that health spending will grow on average 5.7 percent each year through 2023, which is 1.1 percentage points greater than the expected rise in GDP over the same period (Millman, 9/3).

The Associated Press: Gov't Forecasts Rising Health Care Inflation
The nation's respite from troublesome health care inflation is ending, the government said Wednesday in a report that renews a crucial budget challenge for lawmakers, taxpayers, businesses and patients. Economic recovery, an aging society, and more people insured under the new health care law are driving the long-term trend (9/3).

USA Today: Health Care Spending Growth Is Slow But Rising
The growth in health spending for 2013 is estimated to have slowed to 3.6%, but the rate will rise to 5.6% for 2014, the report says. The leading contributors to the increased growth are more people being covered through the Affordable Care Act, expected economic growth and the aging population, CMS says. Some of the impact on the older populations is tempered by the fact that Baby Boomers are healthier than many other new enrollees in Medicare as most are coming from private insurance, the study says. Since the 2007-08 recession, economic recovery has been weaker than anticipated, which has tamped down the rate of health care spending (O'Donnell, 9/3).

Politico: Health Care Spending Growth Remains Modest
Something surprising is happening with health care spending in the United States. The population is aging, the economy is improving, more people are getting covered than ever -; and yet a feared surge in spending isn't happening, according to new projections by federal health care actuaries. Numbers released Wednesday by the Centers for Medicare & Medicaid Services show that spending growth last year is expected to have remained very low by historical standards at just 3.6 percent. (The final data have yet to come in.) In 2014, as the economy gains steam and the Affordable Care Act's main coverage provisions kick in, that increase is expected to be 5.6 percent (Norman, 9/3).

The New York Times: 9 Things You Maybe Didn't Know About Mitch McConnell
McConnell and Grimes both have reasons for not pressing Obamacare. It is not exactly a mutual nonaggression pact, but neither McConnell nor Grimes has an interest in focusing on the Affordable Care Act. Grimes has been nudged by some Kentucky Democrats to embrace a law that has nearly halved the state's uninsured population, but she has so far resisted out of fear of giving McConnell any opportunity to link her to an issue so identified with Obama, who is quite unpopular in the state. McConnell criticizes Grimes for supporting the health law, but he and his allies have been more focused on linking her to what they see as the more culturally resonant issue of coal. Even if no one is trumpeting its success on the campaign trail, Obamacare has been successful in Kentucky. This is especially true in the impoverished eastern part of the state, where McConnell hopes to cut into Grimes's margins or even win some traditionally Democratic counties (Martin, 9/3).

The Wall Street Journal: Republicans Woo Women In Midterm Ads
A new television ad in the Colorado Senate race shows a group of women nodding approvingly as the candidate speaks in favor of a provocative idea: selling birth-control pills over the counter. The twist is that the idea comes not from Democratic Sen. Mark Udall, but from his Republican challenger, Rep. Cory Gardner, who once supported outlawing abortion and some forms of contraception. The ad, running in one of the battleground states that could determine whether Republicans win control of the Senate, is part of a broader effort that Mr. Gardner and other GOP candidates are making to cut into one of the advantages Democrats enjoy this year: Support among women voters (Reinhard and Hook, 9/3).

The Washington Post: Is One Hospice The Same As Any Other? No. Why It's Important To Choose Carefully.
After The Washington Post reported last month about a North Carolina hospice accused of over-medicating a patient, Peter Brunnick, the chief of the largest nonprofit hospice in the state, warned readers in a Charlotte Observer opinion piece that "all hospices are not created equal." He urged readers to choose a hospice carefully. In an interview this week, he offered his thoughts on the state of the industry and what consumers can do to shop wisely (Whoriskey, 9/3).

The Wall Street Journal's Pharmalot: AMA Bemoans CMS Sunshine Data Problems: 'It's Hard to Unring the Bell'
Over the past few weeks, the American Medical Association has complained publicly and privately to the Centers for Medicare and Medicaid Services over its so-called Open Payments database, which will display what drug and device makers pay physicians. The system was created in response to concerns that medical practice and research may be unduly influenced by industry. But the database has been plagued by delays and technical glitches. The AMA is concerned that physicians lack the needed time to ensure correct data is displayed and that the public will understood what they see. The database is expected to go live on Sept. 30, but the AMA wants a six-month postponement to compensate for the problems (Silverman, 9/3).

The Wall Street Journal: Powerful New Cancer Drugs Offer Hope-;At Steep Cost
The first of a promising new class of cancer drugs went on sale in Japan this week at an average annual cost of $143,000 a patient, a harbinger of hefty prices the new drugs are expected to command in the U.S. and Europe in coming months. The drug Opdivo, from Ono Pharmaceutical Co. and Bristol-Myers Squibb Co. , is a so-called PD-1 inhibitor, a new type of drug that harnesses the body's immune system to fight tumors, including melanoma. Several other pharmaceutical companies are also developing PD-1 targeting drugs. High prices for the treatments come as concerns mount about the affordability of new drugs. Debate about pricing reached a peak this year with the launch of an expensive new drug for hepatitis C (Loftus, 9/3).

Politico: Can Big Data And Patient-Informed Consent Coexist?
A research network funded with millions by the Affordable Care Act will begin conducting vast studies next year to compare standard medical treatments. But what about the 100 million patients in the network -; do they have a choice in the matter? Will researchers get permission from each of those patients? And if patients are told about the studies, what, exactly, will they be told? These questions have bioethicists, scientists and health care officials debating how to bring the question of patient informed consent into the 21st century (Allen, 9/3).

The New York Times: Texas Abortion Clinic To Reopen After Ruling
An embattled abortion clinic in McAllen, Tex., which was the last provider of abortions in the vast Rio Grande Valley when new state restrictions forced it to stop last fall, will start operating again by this weekend, its owner said Wednesday, after last week's favorable decision by a federal judge (Eckholm, 9/3).

Los Angeles Times: Why A 3% Benefits Surcharge? Suzanne Goin, Josiah Citrin, Josh Loeb Explain
Josiah Citrin's Melisse and Suzanne Goin's Lucques, The Larder restaurants, Tavern and the new AOC are just the latest in a group of Los Angeles restaurants implementing a 3% employee benefit surcharge to all guest checks. … If customers have a problem with the surcharge, they can adjust their tip percentages to subtract the 3% or ask to have it removed. The restaurants will provide information on what the money is being spent on and will save any extra funds for future healthcare costs. Goin says she was thinking about healthcare for her employees even before the Affordable Care Act, which requires businesses that employee more than 100 to provide health benefits to full-time employees by 2015. Her restaurants were already paying for full benefits for managers and partial benefits for employees (Harris, 9/3).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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