Kaiser Health News Original Stories

3. Political Cartoon: 'Sit Out'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Sit Out'" by Roy Delgado.

Here's today's health policy haiku:

POLL SHOWS PUBLIC SUPPORT FOR CANCER RESEARCH INVESTMENT

Shooting for the moon …
Public supports more research.
Aiming for a cure.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Health Law Issues And Implementation

4. CBO: Health Law Costs Rising, In Part Due To Medicaid Enrollment Numbers

The Congressional Budget Office noted that other provisions in the Affordable Care Act will keep it from adding to the long-term debt of the country, and it says the total cost is 25 percent less than expected when the legislation was signed six years ago.

The New York Times: Report Offers A Mixed View Of Health Care Law Costs
More people will be enrolled in Medicaid than predicted a year ago, fewer will be covered through the new public insurance marketplaces and the overall cost of insurance coverage under the Affordable Care Act will be higher than expected last year, the Congressional Budget Office said Thursday. But the cost of insuring people will be substantially lower than the budget agency expected when the law was passed, on party-line votes, in 2010. It now estimates that the cost will total $465 billion in 2016-19, which is 25 percent less than its original estimate. (Pear, 3/24)

The Washington Post: Budget Scorekeeper: Obamacare Costs Rising As More Enroll In Medicaid
The budget office attributed the vast majority of the expected cost increase to greater-than-expected Medicaid enrollment numbers. Overall, CBO projected, the cost to the government of those enrolled in Medicaid and in the marketplaces created under the law will be $1.4 trillion over 10 years, which is $136 billion more than the scorekeeper previously expected. (Snell, 3/24)

The Hill: CBO: Cost Of ObamaCare Subsidies Climbs By 11 Percent
The cost is also going up by about $28 billion because of Congress's recent legislation that postponed what's called the "Cadillac tax," on high-cost insurance plans. That bill also made the tax deductible to employers, further decreasing the amount of money the Affordable Care Act pulls in. (Ferris, 3/24)

Modern Healthcare: Projected ACA Costs Rise By $136B Due To Robust Medicaid Enrollment
Between 2016 and 2025, the federal government will spend $1.34 trillion on the ACA's primary health coverage provisions. That mostly includes subsidies for the marketplaces and Medicaid expansion, and is partially offset by revenue-generating measures such as penalties tied to the individual and employer mandates. That total is up from the CBO's projection last March of $1.2 trillion but nearly identical to the $1.35 trillion estimate made in January 2015. The shift underscores how difficult it is for economists to predict the costs of a healthcare law that has evolved every year. (Herman, 3/24)

The Wall Street Journal: Enrollment In Health Law’s Exchanges Projected To Reach 12 Million In 2016
Enrollment under the Affordable Care Act’s insurance exchanges is projected to reach about 12 million people in 2016, congressional budget analysts said in a report Thursday that illustrates the Obama administration’s ongoing challenge in getting the remaining uninsured covered. The projection, from the Congressional Budget Office and staff of the Joint Committee on Taxation, was down from an estimate of 13 million in January and 21 million a year ago. (Armour, 3/24)

The Hill: CBO Trims Tally For ObamaCare Enrollment
The Congressional Budget Office on Thursday slightly lowered its projections for ObamaCare enrollment, trimming its tally by about 1 million people. About 12 million people are now expected to have ObamaCare coverage by the end of 2016, according to the nonpartisan budget office. Just three months ago, the office had predicted that 13 million people would have coverage. (Ferris, 3/24)

5. Ark. Governor Finds Himself In Unlikely Role Of Trying To Rescue Medicaid Expansion

Asa Hutchinson was an ardent foe of the federal health law, but as governor he is working to convince other Republicans in the legislature to keep the program started by his Democratic predecessor. Also, lawmakers in Idaho are dealing with the issue of expansion as the session winds down.

The Associated Press: 'Obamacare' Foe Tries To Save Expanded Medicaid In Arkansas
But two years after winning office with 55 percent of the vote, [Arkansas Gov. Asa] Hutchinson has executed a surprising political turnabout and become the leading rescuer of the one of "Obamacare's" most embattled elements, the expansion of Medicaid. He's now imploring Republican lawmakers to keep Arkansas' hybrid version of the expanded insurance program for low-income people, which was pushed through by his Democratic predecessor, Mike Beebe, and is warning about the potential impact of ending it for a rural state with limited revenue and many living near the poverty line. (DeMillo, 3/24)

Idaho Statesman: Idaho Senate Brings Back Medicaid Expansion Bill
Rejecting action by the House a day earlier, the Idaho Senate on Thursday resurrected a proposal to begin prompt negotiations with federal officials for a way to provide subsidized health care for 78,000 poor Idahoans who have none. ... Gov. Butch Otter told the Times-News Thursday that he supports beginning the Medicaid expansion waiver application process as soon as possible. “The sooner that we can start that, the better prepared we’re going to be,” he said. (Dentzer, 3/24)

Twin Falls (Idaho) Times-News: Legislature Down To The Wire On Medicaid Plan
The Idaho House will meet again on Good Friday to vote on a bill that would have the director of the Department of Health and Welfare apply for a Medicaid expansion waiver, paving the way for an Idaho-run health program designed for the state’s working poor. The Senate finished up for the year Thursday evening after passing both the waiver bill and a related funding bill. The House also passed the funding bill 40-29 Thursday evening before adjourning for the day, setting up Friday’s expected waiver debate. (Brown, 3/25)

The Associated Press: Idaho's Health Care Gap Dominates Last Days Of Legislature
Idaho House lawmakers on Thursday punted on approving a proposal to allow the Idaho Department of Health and Welfare to apply for a Medicaid waiver to provide health insurance for people who have incomes below 100 percent of the federal poverty line. House Speaker Scott Bedke says the House will take up the contentious legislation on Friday, the same day the Legislature would adjourn for the year. (Kruesi, 3/25)

6. Unlike Federal Policy, County Programs Often Use Tax Dollars To Treat Illegal Immigrants

The federal health law prohibits selling health insurance on the marketplaces to people in the country illegally. But counties that offer programs that pay for doctor visits, shots, prescription drugs and lab tests for these immigrants say it's cheaper, easier and safer to offer the services rather than treat them in emergency departments.

The Wall Street Journal: Illegal Immigrants Get Public Health Care, Despite Federal Policy
When federal lawmakers wrote the act overhauling the nation’s health-care system six years ago, they ruled out any possibility of extending health insurance to illegal immigrants. Local officials where many of those immigrants live are treating them anyway. A Wall Street Journal survey of the 25 U.S. counties with the largest unauthorized immigrant populations found that 20 of them have programs that pay for the low-income uninsured to have doctor visits, shots, prescription drugs, lab tests and surgeries at local providers. ... County politicians figure it is cheaper, safer and easier to give basic health services to immigrants who can’t get insurance than to treat them only in the county’s emergency rooms. (Radnofsky, 3/24)

In other health law news —

The Washington Post's Wonkblog: Why Pediatricians Care So Much About The Supreme Court’s Birth Control Case
For the second time in two years, the Supreme Court justices tangled over a question about personal beliefs and birth control: Must employers who are religiously opposed to it cover it in their health plans? A prominent group of pediatricians hopes the answer will be yes. Erecting hurdles to the pill, in this case, could jeopardize the health of America’s children, said Benard Dreyer, president of the the American Academy of Pediatrics. It could even encourage the next Disneyland measles outbreak. ... “There’s no discernible difference between a religious objection to contraception and a religious objection to a vaccine,” said Dreyer. (Paquette, 3/24)

Administration News

7. FDA Encourages Generic Drugmakers To Develop Harder-To-Abuse Painkillers

The agency has approved five brand-name drugs that are designed to deter abuse -- such as being hard to crush -- but those represent a small fraction of the field that is dominated by less expensive generics.

The Wall Street Journal: FDA Issues New Generic Painkiller Guidance Amid Opioid-Abuse Concerns
The Food and Drug Administration on Thursday gave guidance to support the development of generic versions of approved abuse-deterrent opioids, the agency’s latest step to reduce deaths from abuse of the powerful drugs. As the FDA pushes the industry to develop pain medicines that are more difficult or less rewarding to abuse, it is recommending studies to demonstrate that a generic opioid is no less abuse-deterrent than the brand name product. (Steele, 3/24)

The Associated Press: FDA Outlines Standards For Anti-Abuse Generic Painkillers
The Food and Drug Administration published draft guidelines outlining testing standards for harder-to-abuse generic painkillers. The agency has already approved five brand-name opioid pain drugs which are designed to discourage abuse. The current version of OxyContin, for example, is difficult to crush, discouraging abusers from snorting or dissolving the tablets to get high. But these abuse-deterrent painkillers represent a small fraction of the market for opioid pain drugs, which is dominated by low-cost generics. (3/24)

Meanwhile, a new survey shows that 99 percent of doctors overprescribe opioids, and, in Massachusetts, a rising number of drug-dependent babies are being born —

Medicare

8. Medicare Backs Away From Plan To Penalize Doctors Ordering Some Prostate Cancer Tests

The proposal sparked a wave of criticism. Also, federal officials say they will test whether paying more to skilled-nursing facilities can help reduce hospital admissions.

The Wall Street Journal: Medicare Officials Halt Proposal To Penalize Doctors For Some Prostate Cancer-Screening Tests
Medicare officials said they have temporarily abandoned a proposed measure that would have penalized doctors for ordering “non-recommended” prostate-specific antigen tests to screen for prostate cancer, citing a wave of negative comments. The proposal, part of the federal effort to define and reward quality in health-care services, sparked confusion and criticism among urologists and others who said whether men should be screened for prostate cancer remained too controversial to link to a penalty in Medicare reimbursement. (Beck, 3/24)

Modern Healthcare: CMS Will Test Paying More For Skilled Nursing To Curb Hospital Readmissions
The CMS will test whether paying skilled-nursing facilities more will help reduce avoidable hospital admissions among their long-term-care residents. Industry stakeholders say the move acknowledges the role of post-acute-care facilities in improving quality of care, a role integral to the upcoming bundled payment model. The new skilled-nursing payment policy would affect individuals who are in either Medicare or Medicaid, or eligible for both programs. (Dickson, 3/24)

Pharmaceuticals

9. Jury Awards Merck $200M In Hep C Patent Dispute

There will be a separate hearing to to determine what Gilead Sciences owes the company in royalties. In other pharmaceutical news, lawmakers ask Valeant investor William Ackman to provide information on drug prices.

The Wall Street Journal: Gilead To Pay Merck $200 Million In Damages Over Hepatitis C Drug Patents
A federal jury in California ordered Gilead Sciences Inc. to pay Merck & Co. and a partner $200 million for infringing two Merck patents in a case involving Gilead’s two blockbuster drugs for treating hepatitis C, Merck said Thursday. The award follows the jury’s decision on Tuesday upholding the validity of two patents held by Merck and its partner Ionis Pharmaceuticals Inc. that Merck says should entitle the companies to a portion of the sales of Gilead’s drugs Sovaldi and Harvoni. (Winslow, 3/24)

Reuters: Ackman's Hedge Fund Cooperating With U.S. On Drug Pricing Probe: Letter
Billionaire investor William Ackman, whose hedge fund is one of the biggest investors in drug company Valeant, has been asked to supply information to U.S. legislators probing price hikes in the pharmaceutical industry. Ackman told investors in his Pershing Square Capital Management on Thursday that the firm received a request on Friday from the U.S. Senate Special Committee on Aging as part of an investigation into pricing of off-patent drugs. (Herbst-Bayliss, 3/24)

Women’s Health

10. Indiana Governor Signs Law Banning Abortions Motivated By Fetal Defects

The legislation also dictates how to dispose of an aborted fetus, and requires doctors performing abortions to have admitting privileges at a hospital or to have an agreement with a doctor who does.

The New York Times: Indiana Governor Signs Abortion Bill With Added Restrictions
Indiana’s governor signed a bill on Thursday that adds broad limits to women’s access to abortions, banning those motivated solely by the mother’s objection to the fetus’s race, gender or disability, and placing new restrictions on doctors. The law, which passed both chambers of the Republican-controlled General Assembly with large majorities, builds on Indiana’s already restrictive abortion rules, and was cheered by anti-abortion groups that had encouraged Gov. Mike Pence to sign it. (Smith, 3/24)

The Associated Press: Indiana Governor Signs Fetal Defects Abortion Ban Into Law
Republican Gov. Mike Pence signed a bill into law Thursday making Indiana the second state to ban abortions because of fetal genetic abnormalities such as Down syndrome. Pence signed the measure just hours ahead of his deadline to take action on the proposal approved by the Republican-dominated Legislature two weeks ago, the governor’s office said. It is due to take effect in July, but Planned Parenthood of Indiana and Kentucky said it will ask a court to block the measure before that can happen. (Chokey, 3/24)

In other news, The Washington Post's Fact Checker examines Republican presidential candidate John Kasich's abortion record in Ohio —

The Washington Post's Fact Checker: John Kasich’s Abortion Policies In Ohio: Pro-Life Except For Rape, Incest And Life Of The Mother?
Ohio is often considered a success story for opponents of abortion rights and an oppressive state for abortion-rights supporters. Yet voters listening to Kasich on the campaign trail may never know the significance of Ohio in the abortion debate. As he acknowledges, Kasich doesn’t like to like to talk about the issue or answer questions directly when asked about it. That’s where we come in. We took a deeper look at Kasich’s record on passing laws related to women’s access to abortions and whether his record reflects his antiabortion view with the exceptions of rape, incest and the life of the mother. (Lee, 3/25)

Public Health And Education

11. Poll: Cancer 'Moonshot' Garners Sweeping, Bipartisan Support From Public

The STAT-Harvard poll found that 90 percent of Democrats and 79 percent of Republicans support at least a 20 percent boost in cancer research spending. In other public health news, older Americans' vitamins could be interacting with their medications with dangerous results, new evidence emerges that could help suss out where else in the world Zika is hiding and scientists create a cell with the smallest number of genomes possible.

STAT: Cancer Research 'Moonshot' Wins Enthusiastic Support In STAT-Harvard Poll
The American public has enormous confidence in the progress being made against cancer — perhaps more than warranted by actual treatment gains — and their faith is translating into overwhelming support for the Obama administration’s proposal to increase cancer research spending, a new STAT-Harvard poll finds. (Nather, 3/25)

The Washington Post's Wonkblog: Older Americans Are Taking Their Vitamins — And That Could Be Dangerous
The number of older Americans at risk for a potentially life-threatening drug interaction doubled between 2005 and 2010, according to a new study -- but not just from the prescriptions they fill at the pharmacy or the medicines they buy over the counter. The study of more than 2,000 people between ages 62 and 85 found that the majority of potentially dangerous drug combinations came from interactions between conventional drugs, such as a blood pressure drug and a cholesterol drug that together can increase risk of muscle damage and kidney failure. But there was an alarming uptick in the number of older Americans taking unproven vitamins and supplements, too -- a scary trend since the safety of those combinations is poorly understood. (Johnson, 3/24)

NPR: Scientists Build A Live, No-Frills Cell That Could Have A Big Future
Scientists announced Thursday that they have built a single-celled organism that has just 473 genes — likely close to the minimum number of genes necessary to sustain its life. The development, they say, could eventually lead to new manufacturing methods. Around 1995, a few top geneticists set out on a quest: to make an organism that had only the genes that were absolutely essential for its survival. A zero-frills life. It was a heady time. (Bichell, 3/24)

Meanwhile, the CDC says an ad campaign helped 104,000 people quit smoking, and tobacco lobbies are going full force in California —

The Hill: CDC: 104K People Quit Smoking Due To Ad Campaign
A government advertising campaign led 104,000 Americans to quit smoking, according to the Centers for Disease Control and Prevention (CDC). In addition, 1.4 million people attempted to quit smoking as a result of the 2014 ad campaign, the CDC said, citing survey results published in the journal Preventing Chronic Disease. (Sullivan, 3/24)

Center for Public Integrity: How Big Tobacco Lobbies To Safeguard E-Cigarettes
Nowhere has the tobacco fight been bigger, or more expensive, than in California, which has attracted at least two-thirds of tobacco companies’ state-level political donations since 2011. Public health advocates here say tobacco companies have used a potent combination of campaign contributions and behind-the-scenes lobbying to win enough friends in key places. The strategy is most apparent on the Assembly’s Governmental Organization Committee, which oversees an odd combination of issues, including public records, state holidays, gambling, alcohol and tobacco. (Kusnetz, 3/25)

12. Investigation: NFL's Concussion Research Was Flawed

The New York Times investigated what and when the NFL knew about the link between football and degenerative brain disease. The NFL, however, responded by saying the piece is "contradicted by clear facts that refute both the thesis of the story and each of its allegations."

The New York Times: In N.F.L., Deeply Flawed Concussion Research And Ties To Big Tobacco
The National Football League was on the clock. With several of its marquee players retiring early after a cascade of frightening concussions, the league formed a committee in 1994 that would ultimately issue a succession of research papers playing down the danger of head injuries. Amid criticism of the committee’s work, physicians brought in later to continue the research said the papers had relied on faulty analysis. Now, an investigation by The New York Times has found that the N.F.L.’s concussion research was far more flawed than previously known. (Schwarz, Bogdanich and Williams, 3/24)

State Watch

13. N.M. University Health Center Rejected Request For $50M To Help Cover Medicaid Shortfall

The request came during the closing days of the legislature, the Albuquerque Journal reports. Also, under Iowa's new Medicaid managed care program, enrollees will not be able to routinely use the Mayo Clinic because the private insurers running the program have not been able to negotiate a contract with the clinic.

Albuquerque Journal: State Asked Health Sciences Center For Medicaid Bailout
The University of New Mexico’s Health Sciences Center turned down a request during the closing days of the Legislature to give the Human Services Department $50 million to help with the state’s Medicaid funding shortfall. ... UNM’s Health Sciences Center has more than $200 million in reserves from its various operations, part of which it wants to use for a proposed new hospital to replace its aging facilities. (Quintana, 3/24)

Des Moines Register: Mayo Rebuffs Iowa Medicaid Managed-Care Contracts
Iowans with Medicaid health coverage will not be able to routinely use the Mayo Clinic after the state shifts the $4 billion program to private management next week. The three managed-care companies that will run Iowa’s Medicaid program told legislators this week they’ve been unable to negotiate contracts with Mayo’s famed hospital system, which is just across the border in Rochester, Minn. (Leys, 3/24)

14. Miss. Senate Approves Bill On Medicaid Electronic Records

A Mississippi Senate panel considered a measure that would require electronic health records and regular audits for the state's Medicaid program. In other news, the Vermont House defeats a narrow exemption for contraception coverage and supporters of a medical cannabis program rally on the Iowa state capitol's steps.

The Associated Press: Bill Would Computerize Medicaid Records, Audit Recipients
Mississippi Senate committee has passed a narrower version of a bill that would require an electronic records system for Medicaid and regular audit of Medicaid recipients. House Bill 1116 would contract an outside company to build a computerized record of Medicaid recipients' information. The Senate version would have Medicaid officials then verify recipients' financial information and residency to determine if they're still eligible for aid. Any recipient found to have moved out of state would stop getting aid within three months. (Benchaabane, 3/24)

The Des Moines Register: Rally Calls For Bipartisan Support Of Medical Cannabis
Hundreds of Iowans gathered on the Capitol steps Tuesday to tell state lawmakers that it's time to approve a comprehensive, safe medical cannabis program. The crowd of nearly 200 at the Rally for Compassionate Cannabis included patients, caregivers, legislators and local government officials. They stood with signs that read "Stop the Suffering" while speakers shared sometimes emotional stories about their experiences with medical cannabis. (Norvelli, 3/24)

15. State Highlights: Group Of Large Texas Hospitals Forms Network; Mass. Program Seeks Out Sickest, Poorest Hard-To-Reach Residents

News outlets report on health issues in Texas, Massachusetts, Wisconsin, Colorado, Ohio, New Jersey, Minnesota, Virginia and Connecticut.

The Boston Globe: Mass. Health Program Searches For The Hard-To-Reach
[Delis] Rivera is among a new cadre of health care workers enlisted in an ambitious Massachusetts experiment to improve care and reduce costs for some of the state’s sickest and poorest residents. The first-in-the-nation program, called One Care, is for people on both Medicare and Medicaid, those living with disabilities, and with little or no income. Their care is managed by one of two nonprofit health insurers, Tufts and Commonwealth Care Alliance. (Dayal McCluskey, 3/25)

The Texas Tribune: Texas Planned Parenthood Affiliate Joins Lawsuit Over Secret Videos
A Texas-based Planned Parenthood affiliate on Thursday moved to join a federal lawsuit filed in California against the anti-abortion group behind undercover videos of the organization’s clinics. The lawsuit, filed in a San Francisco-based federal court in January, alleges the Center for Medical Progress engaged in conspiracy, fraud and other activities that violate organized crime law and other federal regulations in its pursuit of secretly recorded videos of Planned Parenthood. Citing recordings of staff at a Houston clinic, Planned Parenthood Gulf Coast filed to join the lawsuit as a plaintiff. (Ura, 3/24)

The Cincinnati Enquirer: Community Paramedicine Can Add Followups To EMS Service
Emergency medical programs across the country are studying ways to get medical services to the people who need them, and community paramedicine is a program getting a lot of attention. EMS programs in Springfield Township and Colerain Township are both investigating how to best use a paramedicine model in their communities. (Key, 3/24)

The Denver Post: $3M Of Fraudulent Medicaid Billings Recovered From Colorado AG
More than $3 million of fraudulent Medicaid billings were recovered after an 18-month investigation revealed that eight Colorado anesthesia providers were allegedly charging patients incorrectly. A total of $3,020,953 was recovered by the Colorado Attorney General's Medicaid Fraud Control Unit, according to a news release from the AG's office Tuesday. (3/24)

The Associated Press: License Revoked From Doctor Who Bilked Insurers
New Jersey's Board of Medical Examiners has revoked the license of a doctor who bilked insurers of $280,000. Sixty-one-year-old Albert Ades of Englewood billed insurers, including Medicare and Medicaid, for face-to-face nonexistent office visits from 2005 through June 2014. He pleaded guilty last year to health care fraud and agreed to forfeit his medical license. (3/24)

Health Policy Research

16. Research Roundup: Young Adult Coverage; Medicaid Mentors; Getting Dental Care

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: Young Adult Insurance Coverage And Out-Of-Pocket Spending: Long-Term Patterns
The Affordable Care Act appears to have improved health insurance coverage for young adults (ages 18–30). But data from twenty national surveys conducted between 1977 and 2013 paint a more complex picture, showing coverage rates lower in 2013 than they were thirty-six years earlier. Racial and ethnic disparities in coverage have declined recently, while out-of-pocket expenditures remain low for most young adults. (Berk and Fang, 3/23)

Pediatrics: Parent Mentors And Insuring Uninsured Children: A Randomized Controlled Trial
We conducted a randomized trial of the effects of parent mentors (PMs) on insuring uninsured minority children. PMs were experienced parents with ≥1 Medicaid/CHIP-covered child who received 2 days of training, then assisted families for 1 year with insurance applications, retaining coverage, medical homes, and social needs .... PMs were more effective ... than traditional methods in insuring children (95% vs 68%), and achieving faster coverage (median = 62 vs 140 days), high parental satisfaction (84% vs 62%), and coverage renewal (85% vs 60%). PM children were less likely to have no primary care provider (15% vs 39%), problems getting specialty care (11% vs 46%), unmet preventive (4% vs 22%) or dental (18% vs 31%) care needs, dissatisfaction with doctors (6% vs 16%), and needed additional income for medical expenses (6% vs 13%). (Flores et al., 3/17)

Health Affairs: Workplace And Public Accommodations For Nursing Mothers
Although the ACA requires many employers to provide nursing mothers with reasonable break time and private space to express breast milk, a recent study found that only 40 percent of women who gave birth in 2011 or 2012 and returned to work postpartum reported having access to both of these accommodations. A May 2015 report documented that women continued to face challenges in accessing no-cost lactation support and supplies under the new health insurance coverage requirement, and additional anecdotal evidence suggests significant variability in implementation of these provisions. ... statutes supporting breastfeeding vary markedly among states. (Yang, Saunders and Kozhimannil, 3/17)

The Kaiser Family Foundation: Access To Dental Care In Medicaid: Spotlight On Nonelderly Adults
Dental benefits for Medicaid adults are not required by federal law, but are offered at state option, and most states provide only limited coverage .... The progress that states have made in increasing children’s access to and use of dental care, by building stronger provider networks, leveraging accountability through contracts, and investing in care coordination efforts, provides a foundation for similar action for adults in Medicaid. States are also expanding the dental workforce by removing scope-of-practice barriers and through targeted efforts among dental schools to increase diversity among dental students, as under-represented minority students are more likely to provide care to the underserved. Finally, state Medicaid programs are implementing a host of payment and delivery reforms in pursuit of higher-quality care, better patient outcomes, and reduced costs. (Hinton and Paradise, 3/17)

The Kaiser Family Foundation: Trends In Employer-Sponsored Insurance Offer And Coverage Rates, 1999-2014
The majority of nonelderly people get their health coverage through an employer-based plan. This issue brief uses data from the National Health Interview Survey (NHIS) to examine trends in employer-sponsored health insurance (ESI) for different types of people and households. While ESI remains the leading source of coverage for nonelderly people (those under age 65), the percentage covered by an employer plan has declined over the last fifteen years. A similar pattern exists with firm offer rates; fewer workers were offered health insurance from their employer in 2014 than in 1999. The decrease in offer and coverage rates has not been universal; families with low and modest incomes have been most affected by the decline. (Long et al., 3/21)

Urban Institute: Marketplace Plan Choice: How Important Is Price? An Analysis Of Experiences In Five States
Anecdotal evidence has suggested that marketplace consumers are extremely sensitive to premium price when purchasing insurance. We have analyzed available insurer level enrollment data from the five state based marketplaces (California, Rhode Island, New York, Maryland, and Connecticut) which have released the relevant data. We find that consumers are generally quite sensitive to premium price and low cost insurers tend to enroll the largest share; however there are still a significant number of enrollees who have selected higher priced options indicating there are other significant motivations for selecting a particular insurer including brand name recognition, prior satisfaction, or perceived quality differences. (Holahan, Blumberg and Wengle, 3/23)

Here is a selection of news coverage of other recent research:

Medscape: Most US Voters Approve of Paying Kidney Donors, Survey Finds
Most US voters view living kidney donations positively, according to a telephone survey, and most also said they would be motivated toward such a donation if they received $50,000 in compensation. A quantitative survey of 1011 registered US voters likely to vote found that 689 people (68%) would donate a kidney to anyone, and 235 (23%) would donate only to certain people; 87 (9%) would not donate. ... Thomas G. Peters, MD, from the University of Florida College of Medicine in Jacksonville, and colleagues report the survey results in an article published online March 23 in JAMA Surgery. (Frellick, 3/23)

Reuters: U.S. Heart Disease Rates Decline
Over the last 40 years, heart disease rates have dropped in the U.S. overall, but the changes varied widely by region, with the highest rates of the disease shifting from the Northeast to the South, researchers say. “Heart disease” refers to several conditions including coronary artery disease, which can cause heart attack. Despite the decline in deaths over time, heart disease is still the leading cause of death in the U.S., killing more than 600,000 people per year, according to the Centers for Disease Control and Prevention (CDC). (Doyle, 3/21)

CBS News: Many Seniors Using Dangerous Drug Combinations
One in six seniors in the U.S. regularly uses potentially dangerous combinations of prescription and over-the-counter medications and dietary supplements, according to new research. The study, published today in JAMA Internal Medicine, showed a two-fold increase over a five-year period. (Welch, 3/21)

NPR: Stand To Work If You Like, But Don't Brag About The Benefits
Too much sitting increases heart failure risk and disability risk, and shortens life expectancy, studies have found. But according to an analysis published Wednesday of 20 of the best studies done so far, there's little evidence that workplace interventions like the sit-stand desk or even the flashier pedaling or treadmill desks will help you burn lots more calories, or prevent or reverse the harm of sitting for hours on end. "What we actually found is that most of it is, very much, just fashionable and not proven good for your health," says Dr. Jos Verbeek, a health researcher at the Finnish Institute of Occupational Health. (Chen, 3/17)

Reuters: Financial Burden Of Cancer Can Harm Quality Of Life
Almost a third of U.S. cancer survivors face financial burdens, and physical and mental health tends to be worse for those who do, according to a new study. There are more than 14 million cancer survivors in the U.S., the authors wrote in a paper released by the journal Cancer. (Doyle, 3/14)

Reuters: For Low-Income Smokers, Calling A Quitline May Cost Too Much
Telephone quitlines offer free and effective treatment for tobacco dependence, but for low-income smokers who only have a cell phone and don’t have unlimited minutes, calls to the quitline may take a substantial portion of their cell minutes for the month, according to a new study. The researchers didn’t ask smokers if this limitation affected whether or not they used the quitlines, but estimated for how many smokers this might potentially be an issue based on phone ownership and service plans. (Doyle, 3/11)

Reuters: Many Parents Unaware Of Newborn Hearing Screenings
Many parents don't remember if their children were tested for hearing loss at birth, a new study found. Diagnosis and treatment of hearing loss at birth is critical to lowering the risk of impaired speech, language and literacy later in life, write the researchers in JAMA Otolaryngology - Head and Neck Surgery. (Seaman, 3/11)

Editorials And Opinions

17. Viewpoints: Contraception, Religious Freedom And The Supreme Court; How Insurers' Networks Lead To Surprise Medical Bills

A selection of opinions from around the country.

Bloomberg: What Religious Freedom Means. (It's Complicated.)
The Supreme Court looks like it's going to split 4-4 on whether religious organizations are entitled to have even their health insurance providers exempted from providing contraceptive care under the Affordable Care Act. That much was clear from the justices comments at oral arguments on Wednesday. (Noah Feldman, 3/24)

Los Angeles Times: Surprise! You're Covered For The Hospital, Not The Doctors
After Dave Connors' teenage son broke his leg, he was rushed to an Orange County hospital that Connors knew was in his insurer's coverage network. It was only after the bills recently started arriving that he learned the doctors and anesthesiologist in the operating room were out of network, requiring him to pay thousands of dollars more. (David Lazarus, 3/25)

Modern Healthcare: Democrats, Women More Likely To Think About Healthcare This Election
Most voters say healthcare is either very or extremely important to them as they think about this year's presidential election, but what they actually mean by healthcare varies by party, a new poll shows. Most voters say healthcare is either very or extremely important to them as they think about this year's presidential election, but what they actually mean by healthcare varies by party, a new poll shows. The Kaiser Family Foundation poll released Wednesday found that 36% of registered voters surveyed said healthcare was "extremely important" and 42% said it was "very important." Voters cared most about the economy/jobs and more people said terrorism was extremely important than said the same about healthcare. (Shannon Muchmore, 3/23)

The Baltimore Sun: Warning Labels Don't Get To Root Of Our Addiction Problem
While we all acknowledge there is a persistent abuse of opiod painkillers that causes addiction and overdose in the U.S., having the FDA strengthen the warning labels on these drugs does not get to the root cause of the problem ("FDA adds boldest warning to most widely used painkillers," March 22). Many patients are in need of strong painkillers, and with an aging population we will see that need increase. While some physicians may prescribe too many painkillers, I don't believe that's the main cause of our current epidemic. (Mike Gimbel, 3/24)

The Washington Post: The Most Terrifying Part Of My Drug Addiction? That My Law Firm Would Find Out.
More than 20 years ago, I became an associate at a big New York City firm and almost simultaneously spiraled into alcoholism and drug addiction. Top law firms are filled with academic overachievers who are realizing their dreams when they start work. Upon arrival, though, instead of making a brilliant argument before a judge, these young lawyers may find themselves competing with their similarly gifted peers for the privilege of proofreading documents for a high-ranking partner. If they do a great job, they may get to proofread all weekend. That’s what success can look like. Failure can look much worse. To cope with that life, many need an outlet. Over the years, I have known lawyers with eating disorders, out-of-control shopping habits and extreme exercise addictions. (Lisa F. Smith, 3/24)

Lexington Herald Leader: Don’t Reduce Ky. Medicaid Services For Those With Brain Injuries
We were enjoying a wonderful Christmas Day when it happened eight years ago. My son, Matthew Stoney White, was at the time 23 years old and in his final semester at the University of Kentucky. He had traveled back to Pikeville to enjoy Christmas break with his family. Driving down one of our curvy Eastern Kentucky country roads, he encountered black ice. The car went sideways into a large tree and Matthew received an acquired brain injury. (Mark White, 3/24)

Wichita Eagle: Medicaid Expansion Can Save States Money
There would be some cost increases if Kansas allows a federal expansion of Medicaid, as the state eventually would be responsible for 10 percent of the cost of expansion. But a new national report by the Robert Wood Johnson Foundation notes that expansion also saves money, in part because the federal government would pick up some costs currently paid by states. An expansion proposal by the Kansas Hospital Association is projected to save the state $151 million each year from 2017 through 2020. KHA also estimates that by not expanding Medicaid, Kansas has forfeited more than $1 billion in federal funds since Jan. 1, 2014. (Phillip Brownlee, 3/24)

The New York Times: The Racism At The Heart Of Flint’s Crisis
An important new report makes clear the principal cause of the water crisis in Flint, Mich.: the state government’s blatant disregard for the lives and health of poor and black residents of a distressed city. The report released Wednesday by a task force appointed last year by Gov. Rick Snyder to study how Flint’s drinking water became poisoned by lead makes for chilling reading. While it avoids using the word “racism,” it clearly identifies the central role that race and poverty play in this story. “Flint residents, who are majority black or African-American and among the most impoverished of any metropolitan area in the United States, did not enjoy the same degree of protection from environmental and health hazards as that provided to other communities,” the report said. (3/25)

Detroit Free Press: Time To Govern, Move Forward To Fix Flint
The abundant deficiencies of Gov. Rick Snyder's administration are laid bare in a scathing report issued Wednesday by the task force the governor himself appointed to postmortem the Flint water crisis. The appointment of this task force was the governor's response, in the days after he finally acknowledged that the water in Flint was not safe to drink, to critics demanding accountability from an administration that for too long seemed unmoved by the events unfolding in Flint. (3/24)

The Columbus Dispatch: Don't Weaken Smoking Ban
A bill that proposes to carve out exceptions in the state’s Smoke-Free Workplace Act contradicts the will of Ohioans who voted overwhelming to enact the indoor smoking ban through a 2006 ballot measure. Today roughly 1 in 5 Ohioans smoke, about the same as then. But there’s even less tolerance for secondhand smoke given what has become a mountain of medical evidence about the serious health problems it causes bystanders. Among the risks, according to the Ohio Department of Health, are stroke, heart disease, lung cancer, emphysema, pneumonia and, for babies whose moms are exposed, premature birth and Sudden Infant Death Syndrome. (3/25)

The Des Moines Register: Childhood Trauma Plays Role In My Obesity
I recently wrote about a woman who is dying of lung cancer. Someone asked me if the subject of my story smoked. She didn't. The question is, in a way, a natural outgrowth of decades of anti-smoking campaigns. The link between smoking and lung cancer is scientific fact. (Daniel P. Finney, 3/25)