First Edition: September 26, 2014

Today’s headlines include a variety of political and health policy stories.

Kaiser Health News: Debate Grows Over Employer Plans With No Hospital Benefits

Kaiser Health News staff writer Jay Hancock reports: “As companies prepare to offer medical coverage for 2015, debate has grown over government software that critics say can trap workers in inadequate plans while barring them from subsidies to buy fuller coverage on their own. At the center of contention is the calculator — an online spreadsheet to certify whether plans meet the Affordable Care Act’s toughest standard for large employers, the ‘minimum value’ test for adequate benefits” (Hancock, 9/26). Read the story.

Kaiser Health News: DEA: Vicodin, Some Other Pain Meds Will Be Harder to Get

Kaiser Health News consumer columnist Michelle Andrews writes: “The Drug Enforcement Administration is reclassifying so-called ‘hydrocodone combination products’ from Schedule III to Schedule II under the Controlled Substances Act, which will more tightly restrict access. Vicodin, for example, is an HCP because it has hydrocodone and acetaminophen” (Andrews, 9/26). Read the story.

Kaiser Health News: Capsules: Consumer Group Sues 2 More Calif. Plans Over Narrow Networks ; For Gay Men, Gaps In HIV Knowledge, Treatment Persist

Now on Kaiser Health News’ blog, Julie Appleby writes about two California lawsuits regarding narrow networks : “Both cases allege that the insurers offered inadequate networks of doctors and hospitals and that the companies advertised lists of participating providers that were incorrect. Consumers learned their doctors were not, in fact, participating in the plans too late to switch to other insurers, the suits allege, and patients had to spend hours on customer service lines trying to get answers. Both cases seek class action status” (Appleby, 9/25). 

Also on Capsules, Jenny Gold reports on two reports that explore the HIV knowledge gap: “Just 30 percent of gay and bisexual men say they were tested for HIV within the last year as recommended; another 30 percent say they have never been tested. And even when they are tested, only half of those who have been diagnosed with HIV are receiving care and treatment for their infection” (Gold, 9/25). Check out what else is on the blog.

<a href="http://online.wsj.com/articles/a-Medicare-program-loses-more-health-care-providers-1411685388?KEYWORDS=Medicare” data-mce-href=”http://online.wsj.com/articles/a-Medicare-program-loses-more-health-care-providers-1411685388?KEYWORDS=Medicare“>The Wall Street Journal: A Medicare Program Loses More Health-Care Providers

Four more hospital systems recently have dropped out of the Pioneer Accountable Care Organization program, a key part of the federal health law, leaving just 19 of the original 32 participants. Accountable care organizations seek to curb costs by better coordinating care. Hospitals and groups of doctors who keep costs down for large groups of Medicare patients get to share in those savings. But navigating the program’s rules has proved challenging for some hospitals, even those long experienced in coordinated care (Beck, 9/25).

The Washington Post: Obamacare’s Small Business Exchanges Offer Cheaper Health Coverage, Study Shows

During the lead-up to the rollout of the health care law a year ago, President Obama was adamant that new insurance marketplaces for small businesses would provide a start-to-finish online shopping experience for employers, where they could compare and buy plans with the click of a mouse. In addition, he said, by placing rates from different insurers side-by-side and offering tax breaks, the marketplaces would provide less expensive plans that what had been available to small companies (Harrison, 9/24).

The New York Times: A Father’s Last Wish, And A Daughter’s Anguish

He was still her handsome father, the song-and-dance man of her childhood, with a full head of wavy hair and blue eyes that lit up when he talked. But he was gaunt now, warped like a weathered plank, perhaps by late effects of an old stroke, certainly by muscle atrophy and bad circulation in his legs. Now she was determined to fulfill her father’s dearest wish, the wish so common among frail, elderly people: to die at home. But it seemed as if all the forces of the health care system were against her — hospitals, nursing homes, home health agencies, insurance companies, and the shifting crosscurrents of public health care spending (Bernstein, 9/25).

The Associated Press: Senators: Widen Medicaid Program For Frail Seniors

More than a dozen U.S. senators from both parties are calling on the Obama administration to broaden a Medicaid program for the nation’s frailest seniors, calling it a proven alternative to pricier nursing home care as states seek to limit long-term medical costs. In a letter released Thursday, the senators urged the Centers for Medicare and Medicaid Services to follow through on plans to loosen restrictions on the Program of All Inclusive Care for the Elderly. PACE is open to Medicaid-eligible seniors and people with disabilities who need nursing home care (9/25).

The Wall Street Journal’s Washington Wire: With Holder Leaving, Verrilli Is Back in the Spotlight

U.S. Solicitor General Donald Verrilli Jr., who successfully defended President Barack Obama’s signature health-care law in 2012, is among the possible candidates to succeed Attorney General Eric Holder, who is expected to announce Thursday that he will step down. Mr. Verrilli, 57 years old, is a veteran appellate lawyer who in private and government practice has argued numerous high-profile Supreme Court cases. In addition to defending the Affordable Care Act, Mr. Verrilli has represented the U.S. government in major cases before the high court on same-sex marriage, voting rights and this year’s challenge to contraception-coverage requirements under the health law (Adamy and Henderson, 9/25).

The Washington Post: Brady To Battle Ryan For Ways And Means Chairmanship

Rep. Kevin Brady (R-Tex.) said Thursday that he will seek the chairmanship of the powerful House Ways and Means Committee, scrambling what was expected to be a smooth ascension to the post by Rep. Paul Ryan (R-Wis.), the 2012 GOP vice-presidential nominee and the party’s architect of fiscal policy in the House. Brady said in an interview that after months of weighing his options, he has decided to battle Ryan for the gavel. The move could force Ryan’s hand on a 2016 presidential run (Costa, 9/25).

The New York Times: Ad Attacks Skinny-Dipping Congressman

The commercial refers to an incident in which Representative Kevin Yoder went skinny-dipping in the Sea of Galilee with other Republican members during a trip to Israel last year. Ms. Kultala’s ad features sound bites from conveniently covered skinny-dippers lounging at a pool, as nude puns abound about Mr. Yoder’s record. “The naked truth is Yoder voted to cut Medicare for seniors,” says one elderly couple, sidling up to the side of the pool for cover (Corasaniti, 9/25).

Los Angeles Times: Gov. Brown Signs Bills On Birth Control, Inmate Rights

Gov. Jerry Brown on Thursday signed into law bills requiring most health plans to cover a variety of contraceptive methods, banning forced or coerced sterilizations of inmates in California prisons and giving felons behind bars easier access to DNA tests that could prove their innocence. The birth control bill covers contraceptive drugs, devices and products for women, as well as related counseling, follow-up services and voluntary sterilization procedures (McGreevy and Mason, 9/25).

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First Edition: September 26, 2014