First Edition: September 15, 2014

Today’s headlines include reports about how the health law sales pitch is getting an overhaul in advance of the upcoming sign-up period as well as reports about complications that may occur during the open enrollment season.

Kaiser Health News: California To Broaden Autism Coverage For Kids Through Medicaid

Kaiser Health News staff writer Daniela Hernandez reports: “A new initiative seeks to help level the playing field. Starting Monday, September 15,thousands of children from low-income families who are on the autism spectrum will be eligible for behavioral therapy under Medi-Cal, the state’s health plan for the poor. California is among the first states to respond to a recent rule by the U.S. Centers for Medicare & Medicaid Services that requires the therapy to be covered, when deemed medically necessary, as part of a “comprehensive array of preventive, diagnostic and treatment services” for low-income people 21 and under” (Hernandez, 9/15). Read the story, which also ran in the Los Angeles Daily News.

Kaiser Health News: Appeals Court Weighs Texas Abortion Law

KUHF’s Carrie Feibel, working in partnership with Kaiser Health News and NPR, reports: “A federal appeals court in New Orleans is reviewing whether 11 clinics that provide abortion in Texas must immediately close their doors because they don’t comply with a state law requiring that they meet all the standards of an outpatient surgical center” (Feibel, 9/12). Read the story. 

The Wall Street Journal: Health-Law Advocates To Tweak ACA Marketing Campaign For The Fall

The sales pitch for the health law is getting an overhaul for the fall. Supporters and advocates of the Affordable Care Act say they learned lessons from last year’s sign-up effort, when they persuaded a few million uninsured people to buy coverage. They plan to incorporate those lessons into the marketing campaign for the next enrollment period, which begins in mid-November (Radnofsky, 9/14). 

The New York Times: Renewing Health Coverage May Not Be As Automatic As Government Says 

Millions of consumers will soon receive notices from Health Insurance companies stating that their coverage is being automatically renewed for 2015, along with the financial assistance they received this year from the federal government. But consumer advocates and insurers say they see a significant potential for confusion because some of the information will be out of date and misleading on costs and other aspects of coverage. Some people who have been receiving monthly subsidy payments this year could get much less if they stay in their current health plans (Pear, 9/14). 

The Associated Press: Hurdles For Obama Health Law In 2nd Sign-Up Season

Potential complications await consumers as President Barack Obama’s health care law approaches its second open enrollment season, just two months away. Don’t expect a repeat of last year’s website meltdown, but the new sign-up period could expose underlying problems with the law itself that are less easily fixed than a computer system. Getting those who signed up this year enrolled again for 2015 won’t be as easy as it might seem. And the law’s interaction between insurance and taxes looks like a sure-fire formula for confusion (Alonso-Zaldivar, 9/14).

The Associated Press: Melding Health Overhaul And Taxes Gets Complicated 

President Barack Obama’s health care law uses the tax system to subsidize coverage for the uninsured. Promoting social policy goals through the tax code is a time-honored strategy for both political parties. … But melding insurance and taxes — two of the most complicated topics for consumers — won’t be easy (9/14). 

The Washington Post: How States Have Gamed Medicaid For Hundreds Of Millions Of Dollars

States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program. The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address (Hicks, 9/15).

The Associated Press: US Wealth Gap Putting The Squeeze On State Revenue

As the growth of tax revenue has slowed, states have faced tensions over whether to raise taxes or cut spending to balance their budgets as required by law. “Rising income inequality is not just a social issue,” said Gabriel Petek, the S&P credit analyst who wrote the report. “It presents a very significant set of challenges for the policymakers.” Stagnant pay for most people has compounded the pressure on states to preserve funding for education, highways and social programs such as Medicaid. Their investments in education and infrastructure have also fueled economic growth. Yet they’re at risk without a strong flow of tax revenue (9/15).

Politico: A GOP Senate Could Take On Obamacare — But Not Repeal It

A Republican-controlled Senate cannot repeal Obamacare, no matter how fervently GOP candidates pledge to do so on the campaign trail this fall. But if they do win the majority, Senate Republicans could inflict deep and lasting damage to the president’s signature law. Republicans are quick to say they are not yet measuring the proverbial drapes. But they are taking the political measurements of repealing large parts of the health law, considering which pieces could be repealed with Democratic support, and how to leverage the annual appropriations and budget process to eliminate funding or large pieces of the law (Haberkorn, 9/15). 

The New York Times: A Rebound Takes Root In Michigan, But Voters’ Gloom Is Hard To Shake

Another blustery Midwestern winter approaches, but along a blue-collar stretch of Leonard Street in this conservative, famously button-down city, an economic springtime has arrived. … Yet the economic recovery taking root in Michigan — among the states hit hardest by the 2008 recession — has not translated into an improved political environment for officials in either party. … On the lower end, the worst of the desperation has subsided, helped in part by government action. Barbara Grinwis, 63, executive director of Oasis of Hope, a free health clinic on Leonard Street, spends much of her time signing up patients for Michigan’s insurance exchange or expanded Medicaid under the president’s health care law (Weisman, 9/12). 

The New York Times: Building Legacy, Obama Reshapes Appellate Bench

Democrats have reversed the partisan imbalance on the federal appeals courts that long favored conservatives, a little-noticed shift with far-reaching consequences for the law and President Obama’s legacy. … The shift, one of the most significant but unheralded accomplishments of the Obama era, is likely to have ramifications for how the courts decide the legality of some of the president’s most controversial actions on health care, immigration and clean air (Peters, 9/13). 

The Washington Post: In Just A Year Obamacare Goes From Top Congress Issue To Barely Mentioned

It was last September when Republicans sparred with Democrats over the future of the health-care law, a disagreement that prompted a 17-day federal government shutdown and overall chaos. It was pretty much anyone on Capitol Hill talked about. Republicans wanted you to know how terrible it was for America, and Democrats wanted you to remember to sign up on Oct. 1. In that month, a mere 12 months ago, the word Obamacare was uttered on the House and Senate floor 2,753 times, … With just one full week of work left this month, members of Congress have brought up Obamacare in floor speeches just 27 times (Itkowitz, 9/13). 

The Texas Tribune/The New York Times: Texas Group Uses Health Care Issue To Get Hispanics To The Polls 

When Armando Rodriguez opened the front door of his home here on the city’s west side, Chris Ornelas of the Texas Organizing Project met him with one question. “What are some of the biggest concerns you have in your life right now?” Mr. Ornelas asked in Spanish. Health care, Mr. Rodriguez replied, and whether his family could afford it. … The issue of Medicaid expansion resonates strongly with Hispanics, who make up a large portion of the state’s uninsured population. In Harris, Dallas and Bexar Counties — three of the state’s most populous counties — the Texas Organizing Project is working to use Hispanic support of affordable health care to spur a movement that could change the state’s electoral tide (Ura, 9/13). 

Politico: Senate Showdown: GOP Frets Over Harkin Seat 

Few states are more important than Iowa in the battle for the Senate this fall. But anxiety is rising within Republican ranks that deep-pocketed conservative donors and outside groups are not doing enough, as Democrats outspend them by millions of dollars to retain the seat of retiring liberal Sen. Tom Harkin. Since GOP nominee Joni Ernst won the June primary, Democratic Rep. Bruce Braley and his allies have outspent Ernst and her supporters by more than $2.1 million, … Meanwhile, interest groups from the left are piling on. … Braley’s allies stress that he has also been getting hammered with attack ads — many over absences from House Veterans Affairs Committee hearings in the House and support for Obamacare. (Hohmann, 9/14). 

The Wall Street Journal’s Washington Wire: OTC Birth-Control Fight Hits Airwaves In Colorado, North Carolina

Planned Parenthood’s political arm is ratcheting up its fight with some Republican Senate candidates over the issue of possible over-the-counter contraceptives, calling the candidates’ support of OTC pills “empty gestures.” Planned Parenthood Votes jumped into the middle of hotly-contested Senate races in Colorado and North Carolina with television ads denouncing GOP candidates there, Rep. Cory Gardner (R., Colo.) and Thom Tillis (Burton, 9/12).

The Wall Street Journal: Some Cancer Experts See ‘Overdiagnosis,’ Question Emphasis On Early Detection

Early detection has long been seen as a powerful weapon in the battle against cancer. But some experts now see it as double-edged sword. While it’s clear that early-stage cancers are more treatable than late-stage ones, some leading cancer experts say that zealous screening and advanced diagnostic tools are finding ever-smaller abnormalities in prostate, breast, thyroid and other tissues. Many are being labeled cancer or precancer and treated aggressively, even though they may never have caused harm (Beck, 9/14). 

USA Today: Pre-Diabetes, Diabetes Rates Fuel National Health Crisis

Americans are getting fatter, and older. These converging trends are putting the USA on the path to an alarming health crisis: Nearly half of adults have either pre-diabetes or diabetes, raising their risk of heart attacks, blindness, amputations and cancer. Federal health statistics show that 12.3% of Americans 20 and older have diabetes, either diagnosed or undiagnosed. Another 37% have pre-diabetes, a condition marked by higher-than-normal blood sugar. That’s up from 27% a decade ago. An analysis of 16 studies involving almost 900,000 people worldwide, published in the current issue of the journal Diabetologia, shows pre-diabetes not only sets the stage for diabetes but also increases the risk of cancer by 15% (Unger, 9/15). 

USA Today: Schizophrenia Is Eight Different Diseases, Not One

New research shows that schizophrenia is not a single disease, but a group of eight distinct disorders, each caused by changes in clusters of genes that lead to different sets of symptoms. The finding sets the stage for scientists to develop better ways to diagnose and treat schizophrenia, a mental illness that can be devastating when not adequately managed, says C. Robert Cloninger, co-author of the study published today in the American Journal of Psychiatry (Szabo, 9/15). 

The New York Times: Maker Of Hepatitis C Drug Strikes Deal On Generics For Poor Countries

The maker of one of the costliest drugs in the world announced on Monday that it had struck agreements with seven Indian generic drug makers to sell lower-cost versions of its $1,000-a-pill Hepatitis C drug in poorer countries (Harris, 9/15). 

Los Angeles Times: Shortage Of In-Home Dialysis Solution Has Patients Worried

Unlike the hundreds of thousands of Americans who drive several times a week to a dialysis center, Joanna Galeas relies on an increasingly popular at-home alternative to treat her kidney failure. Galeas, a 30-year-old Los Angeles resident, is among tens of thousands of U.S. residents who use peritoneal dialysis at home. She fills her abdomen with a sterile solution that helps remove toxins from her blood, a function ordinarily performed by healthy kidneys (Pfeifer and Terhune, 9/12). 

USA Today: There Is An Epidemic Of Medical Identity Theft

Despite government assurances that the recent hacking of HealthCare.gov did not compromise the security of the personal information of enrollees and the hack was confined to a server that was not supposed to be connected to the Internet, many security experts continue to have doubts about the security of the HealthCare.gov website. And why wouldn’t they? (Weisman, 9/14). 

The Associated Press: Texas Asks Court To Allow Closure Of Most Clinics 

Texas asked a federal appeals court Friday to allow the state to immediately enforce a law requiring all abortion clinics to adhere to costly standards required for walk-in surgical clinics, which would close more than half of the state’s abortion facilities. Texas Solicitor General Jonathan Mitchell asked the 5th U.S. Circuit Court of Appeals to temporarily reinstate the requirement, which was ruled unconstitutional by a lower court last month. The New Orleans-based appeals court has already upheld another new abortion restriction that has shuttered several abortion clinics in Texas (McConnaughey, 9/12). 

Los Angeles Times: Medi-Cal Official To Leave Healthcare Post In January

The official who led California’s giant public healthcare services department through a tumultuous implementation of Obamacare reforms — including a months-long period during which hundreds of thousands of Medicaid applications have languished, waiting to be processed — will depart his position in January, state officials have announced (Brown, 9/12).

The Associated Press: WSU Regents Approve Plan For New Medical School 

Washington State University’s board of regents on Friday unanimously approved the administration’s controversial effort to start a new medical school in Spokane, citing the “dire need” for more doctors in the state. … WSU’s plan is opposed by the University of Washington, which operates the state’s only publicly funded medical school. While approving WSU President Elson S. Floyd’s pursuit of the independent medical school, the regents said the university should continue its partnership with the University of Washington’s WWAMI program, which trains doctors for the states of Washington, Wyoming, Alaska, Montana and Idaho (Geranios, 9/12). 

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First Edition: September 15, 2014