Morning Briefing
Summaries of health policy coverage from major news organizations
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吃瓜不打烊 Original Stories
If You鈥檙e Blindsided By Health Plan Changes, Learn The Root Causes 鈥 And Your Rights
Insurers can reduce benefits or change cost sharing, but they are generally supposed to tell enrollees about the change beforehand. And although plans must tell patients when they are denied coverage, sometimes treatment is affected for other reasons.
Summaries Of The News:
Health Law
Democrats Urge House Republicans To Follow In Senate's Bipartisan Footsteps
Democrats are calling on House Ways and Means Committee Chairman Kevin Brady (R-Texas) to hold bipartisan hearings on stabilizing ObamaCare markets. The committee's Democrats in a letter to Brady dated last Friday request that the panel hold hearings, and cite聽the Senate Health Committee鈥檚 hearings this month as an example. (Sullivan, 9/11)
It's unclear whether Republicans and Democrats on the Senate's Health Committee will be able to reach a deal by the end of the week on a bill to shore up ObamaCare's insurance markets.聽But Democrats are worried Republicans are digging in with conservative ideas, ruining changes at negotiation, a senior Democratic aide told The Hill. (Hellmann, 9/11)
As a key Senate panel continues to seek a bipartisan fix for the Affordable Care Act, the Connecticut Insurance Department on Monday weighed in with its suggestions, including allowing people to buy a new, cheaper, 鈥渃opper-level鈥 plan with fewer benefits and higher out-of-pocket costs. In a letter to Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander, Insurance Commissioner Katharine Wade asked Congress to continue a moratorium on the ACA鈥檚 health insurance tax, a levy that will go into effect next year based on the premium dollars an insurer earns. (Radelat, 9/11)
Sen. Rand Paul (R-Ky.) said Monday that he opposes a new Republican ObamaCare replacement effort, saying it does not go far enough to repeal the law. Paul told reporters that the bill from GOP Sens. Bill Cassidy (La.) and Lindsey Graham (S.C.) would 鈥減robably鈥 be worse than doing nothing at all on the health law. (Sullivan, 9/11)
Sen. Rand Paul (R-Ky.) on Monday said the GOP鈥檚 last-ditch plan to repeal Obamacare is a 鈥渂ad idea鈥 that he doesn鈥檛 see going anywhere. Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) are scrambling to get the 50 GOP votes needed to pass their Obamacare repeal bill before the end of the month, when the Republicans' fast-track option to pass legislation with a simple majority expires in the Senate. (Haberkorn, 9/11)
ACA Navigators Begin Shutting Down Operations
Navigator groups that help educate and enroll consumers in the Affordable Care Act insurance exchanges are shutting down because the federal government isn't paying them. Several navigator organizations, including the University of South Florida, which received the country's largest federal grant for navigation services in 2016, are suspending education and outreach activities ahead of the 2018 open enrollment period that is slated to begin Nov. 1. (Livingston, 9/11)
In other health law news聽鈥
Wagering that the new federal health care law would be a boon, the billionaire investor Larry Robbins bet big on hospital stocks five years ago. Those investments helped propel his hedge fund, Glenview Capital Management, to the ranks of the top-performing funds in 2013. Since then, the bet has soured. Glenview suffered steep losses as the stocks of many for-profit hospital chains sank, hurt by weak earnings and, more recently, by uncertainty over the lasting impact of the law, the Affordable Care Act. (Creswell and Abelson, 9/11)
Equifax Inc., which said last week it suffered a breach that exposed the personal data of 143 million Americans, holds a contract to check incomes and other data of people who bought health insurance in the Obamacare markets. The credit data firm has a聽$329 million, five-year government contract which ends in March to verify the incomes of people purchasing coverage through the health exchanges. The Affordable Care Act provides subsidies to help people afford health insurance depending on their income levels. (Edney and Murphy, 9/11)
Capitol Watch
Lawmakers Enthusiastically Reject Trump's Proposal To Cut NIH Funding
Back in March, when President Trump released the first draft of his budget proposal for the coming fiscal year, he asked lawmakers for deep cuts to one of their favorite institutions, the National Institutes of Health 鈥 part of a broad reordering of priorities, away from science and social spending, toward defense and border security. Six months later, Congress has not only rejected the president鈥檚 N.I.H. proposal; lawmakers from both parties have joined forces to increase spending on biomedical research 鈥 and have bragged about it. (Pear, 9/11)
In other news from Capitol Hill聽鈥
Sen. Cory Booker is throwing his support behind a "Medicare for all" bill being introduced by Sen. Bernie Sanders (I-Vt.), becoming the latest Democrat floated as a 2020 contender to back the legislation.聽The New Jersey senator told聽NJTV News that he would sign on as a co-sponsor of the bill, which is scheduled to be rolled out on Wednesday. (Carney, 9/11)
Public Health
'We Did Really Well': After Bracing For Disaster, Florida Hospitals Breathe Sigh Of Relief
Doctors, nurses and staff at聽hospitals up and down Florida's Gulf and Atlantic coasts were nearly breathless with surprise and relief Monday: Their patients 鈥 and their buildings 鈥 had survived the monster named Irma. 鈥淲e're wonderful,鈥 said Cheryl Garn, spokeswoman聽for Lee Health's four hospitals in Fort Myers. 鈥淢inimum damage. The sun is out and shining. We have some leaks where wind or rain blew in, but the patients are safe and comfortable.鈥 (Nutt, 9/11)
In the wake of Hurricane Irma, Florida hospitals are returning to regular operations, discharging high-risk patients who had sheltered at their facilities during the storm, and preparing for an influx of emergency room visits from people suffering falls, cuts and other mishaps related to the recovery. But not all hospitals and healthcare facilities are ready to rebound after Irma. (Chang, 9/11)
As the worst of Irma neared the end of its path in Georgia Monday evening, many hospitals breathed a sigh of relief. It wasn鈥檛 an easy day: Several Georgia hospitals went to backup generators at some point, including Emory Healthcare鈥檚 orthopedics and spine hospital. (Hart, 9/11)
Stocks of U.S. hospital companies rose on Monday as damage from Hurricane Irma in Florida appeared to be lighter than feared. Shares of Tenet Healthcare Corp rose 3.9 percent, Community Health Systems Inc shares were up 2.8 percent, Envision Healthcare Corp rose 1.7 percent and HCA Health shares were up 1.4 percent in morning trading. (Erman, 9/11)
Before Hurricane Irma arrived, Dr. Kenneth Alexander decided to put together a list of anticipated short-term and long-term injuries after the hurricane so that he and his colleagues could better prepare at the hospital. He started researching the current literature, and to his surprise there were very few studies on the topic. (Miller, 9/11)
Feeding those in need before, during and in the aftermath of a storm like Irma is complicated business. More than 585 shelters opened in the state of Florida in the past few days, with more than 200,000 people housed and fed. (Relley, 9/11)
The northern bands of Tropical Storm Irma knocked out power to more than 400,000 Georgia Power and EMC customers in coastal and South Georgia on Monday morning. More than 80,000 Georgia Power customers were without power in the Savannah area, as were another 94,000 from Brunswick and St. Simons south to St. Marys, at the Florida line, the AJC reported. (Miller, 9/11)
Meanwhile, in Texas聽鈥
Floodwaters in two Houston neighborhoods have been contaminated with bacteria and toxins that can make people sick, testing organized by The New York Times has found. Residents will need to take precautions to return safely to their homes, public health experts said. It is not clear how far the toxic waters have spread. But Fire Chief Samuel Pe帽a of Houston said over the weekend that there had been breaches at numerous waste treatment plants. The Environmental Protection Agency said on Monday that 40 of 1,219 such plants in the area were not working. (Kaplan and Healy, 9/11)
Fifteen patients have scheduled no-cost abortions as part of an effort launched by Whole Woman's Health Clinic to pay for procedures for women affected by Hurricane Harvey. Six of those abortions will take place in the clinic's San Antonio location and nine are scheduled in Austin, a spokeswoman for the clinic said. (Platoff, 9/11)
Treating Diseases With Electrical Pulses Is Compelling Concept, But Evidence That It Works Is Scant
The much-hyped field of 鈥渆lectroceuticals鈥 鈥 which involves zapping nerves with tiny electrical pulses to treat disease 鈥 got another injection of funds late last month with a $30 million investment round for startup SetPoint Medical. Major medical device companies Medtronic and Boston Scientific kicked in funding, as did several venture funds. Global pharma giant GlaxoSmithKline has also invested in SetPoint. (Piller, 9/12)
A federal advisory committee sent a strong message to the Food and Drug Administration on Monday, declaring nearly unanimously that the risks of using certain opioids in children鈥檚 cough medications outweighs the benefits. 鈥淲e have a disease with a very low risk profile, yet we鈥檙e looking at a drug that has a risk of death,鈥 said Dr. Christy Turer, an assistant professor of pediatrics, clinical sciences, and medicine at the University of Texas Southwestern. 鈥淭hat, to me, seems very disproportionate.鈥 (Swetlitz, 9/11)
Following the attacks of Sept. 11, 2001, first responders rushed to ground zero in Manhattan, where they braved dangerous conditions to rescue people buried in the rubble, retrieve the remains of the dead and clear the debris. Among them was demolition supervisor John Feal. Feal arrived at ground zero on Sept. 12; just five days later, he was seriously injured when an 8,000-pound piece of steel fell and crushed his foot. (Gross, 9/11)
Is obesity always unhealthy? Some studies have tried to answer that question by looking at those who are聽鈥渇at but fit鈥 鈥 obese but still physically active. A new study takes a different tack: If people are obese but without other cardiovascular risk factors, do they still have a higher rate of things like heart attack and stroke? The answer, in one of the biggest studies yet to weigh in on the question, is yes. Using an electronic health record database of 3.5 million people, researchers at the University of Birmingham in England separated people into categories based on their body mass index (BMI) and whether they had type 2 diabetes, hypertension, high cholesterol, or more than one of those illnesses. (Sheridan, 9/11)
Men are less likely to return to a new doctor if the doctor is female, according to a new report from athenahealth. Using data from over 2 million visits to primary care doctors, the study found that if the doctor was a woman, men with commercial health insurance would only schedule a return visit about 40 percent of the time. (Chakrabarti, Mitchell and Goldberg, 9/11)
ou can spend a lot of accumulated time on your bottom in the course of a day. Or you can sit for lengthy spells without a break. Both, it turns out, are very bad for you. Whether you鈥檙e a heavy sitter or a binge-sitter, racking up prolonged sedentary time increases your risk of early death, according to a study published in Tuesday鈥檚 edition of the Annals of Internal Medicine. (Healy, 9/11)
A federal task force five years ago recommended against routine screening for prostate cancer. The U.S. Preventive Services Task Force said the PSA screening test often suggested that prostate cancer might be present when there was no cancer 鈥 a result known as a 鈥渇alse positive.鈥 Such results cause worry and anxiety and can result in follow-up tests and procedures, such as biopsies, that aren鈥檛 needed, the task force said. This opposition to routine screening proved controversial, and earlier this year the organization relaxed its position. The new recommendation of the task force said men ages 55 to 69 should decide individually with their doctors whether and when to undergo PSA testing. (Miller, 9/11)
Fewer North Carolinians are getting and filling antibiotic prescriptions over the past five years, and according to infectious disease experts, that鈥檚 a good thing. Data released last month by the national Blue Cross Blue Shield Association showed fewer North Carolina patients filled prescriptions for antibiotics than in any other Southeastern state. Researchers looked at claims submitted by people covered by Blue Cross Blue Shield in almost every state and saw how many people were getting prescriptions for antibiotics. In North Carolina, the number of claims had dropped from 87.4 prescriptions per hundred patients in 2010 to 66.8 prescriptions per hundred patients last year, the second fastest rate of decline in the U.S. (Hoban, 9/11)
Orthopedic surgeons should dissociate themselves from聽football at all levels of the sport rather than enabling an activity that carries a risk of brain injury, according to an editorial by senior editors of a Philadelphia-based orthopedics journal. No team sponsorships, such as the marketing arrangement that the Rothman Institute and Thomas Jefferson University have with the Eagles.聽No standing on the sidelines. No performing sports physicals for high school and college players. (Avril, 9/11)
Women鈥檚 Health
National Dynamics Bump Up Abortion As A Priority In Virginia's Gubernatorial Race
Abortion, a long-simmering issue in Virginia 鈥 a purple state where rural evangelicals sharply differ from urban progressives 鈥 has been elevated in this year鈥檚 gubernatorial contest because of changing dynamics on the federal level. President Trump has vowed to appoint antiabortion judges who could unravel federal protections, turning the power to decide whether women can terminate pregnancies back to governors and state legislatures. (Nirappil, 9/11)
In other news聽鈥
Planned Parenthood Great Plains plans to offer abortion services at two more clinics in Missouri, the organization announced Monday, bringing to three the number of abortion providers in Missouri. Planned Parenthood鈥檚 midtown Kansas City clinic has received an abortion license and will now offer medication abortion services. The organization anticipates its Columbia clinic will offer both medication and surgical abortion services in the coming days. (Smith, 9/11)
State Watch
State Highlights: Conn. Hospitals Wary Of Governor's Tax Plan; Needs Of Appalachia Overlooked In Health Care Debate
Gov. Dannel P. Malloy鈥檚 bid to end the state鈥檚 budget impasse hinges on convincing legislators to take a leap of faith about the state鈥檚 hospital tax. Specifically, the governor is asking for a 55 percent tax increase on hospitals and saying that his new plan to pump the proceeds of that tax hike 鈥 and more 鈥 back into the industry won鈥檛 evaporate as his original one did six years ago. (Phaneuf, 9/12)
They arrived at a fairground in a deep corner of Appalachia before daybreak, hundreds of people with throbbing teeth, failing eyes, wheezing lungs. They took a number, sat in the bleachers and waited in the summer heat for their name to be called so they could receive the medical help they can't get anywhere else. (Lovan, 9/12)
At least 12 patients have contracted a rare infection after heart surgeries at Children's Hospital in New Orleans, according to The New Orleans Advocate. The hospital pointed to a piece of operating room equipment as the source of the infection, which was caused by bacteria known as Mycobacterium Abscessus. ...The Centers for Disease Control and Prevention聽notes that Mycobacterium Abscessus is commonly found in water, soil and dust, and can cause "a variety of infections." Typically, "health-care associated infections" associated with it "are usually of the skin and soft tissues under the skin." (Brasted, 9/11)
A Southern California company has recalled papaya imported from Mexico after health authorities linked its fruit shipments to a salmonella infection that has killed one person and sickened 13 others in three states. Bravo Produce Inc. of San Ysidro, issued a recall notice Sunday, after federal investigators last week traced an infected sample of Maradol papayas to shipments the company imported from a Tijuana packer. (Mohan, 9/11)
California鈥檚 sex offender registry is broken, according to law enforcement officials. ... The registry has become so large, police and prosecutors say, that it often produces too many potential suspects to be useful in solving sex crime cases. (Koseff, 9/11)
Federal health officials said Monday that they are investigating a multistate outbreak of Campylobacter infections traced to puppies sold at Petland, a nationwide chain of about 80 pet stores. The bacteria, a common cause of diarrheal illness that can spread through contact with dog feces, has sickened at least 39 people in Ohio, Kansas, Missouri, Wisconsin, Tennessee, Pennsylvania and Florida. Nine people have been hospitalized since last September, but no deaths have been reported, according to officials with the Centers for Disease Control and Prevention. (Brulliard and Sun, 9/11)
Qventus鈥 software helps health care institutions manage staffing in hospitals and pharmacies. It processes data, including the number of patients and doctors in the hospital, the length of wait times, and where slowdowns are occurring, so that, for example, more nurses can be sent to the area of the hospital where they are most needed, or managers can get the latest information on what rooms need to be cleaned. (Salian and Thadani, 9/11)
For the 176,000 Californians diagnosed with cancer this year, Monday鈥檚 announcement that the University of California鈥檚 five academic cancer centers are forming an alliance to stem the disease鈥檚 rising toll here couldn鈥檛 come soon enough. Experts say cancer is on its way to overtake heart disease as the Golden State鈥檚 leading cause of death. (Seipel, 9/11)
Cuyahoga County will spend $200,000 next year to have a company exterminate bed bugs in homes of seniors and disabled adults.The problem has increased so dramatically that homes are on a waiting list for treatment. (Farkas, 9/11)
Editorials And Opinions
Perspectives: A Bipartisan Path To Insurance Market Stability; Single-Payer's Political Traps
At a meeting in California this spring, we sat down with a number of insurance company chief executives who are major participants in the Affordable Care Act exchanges. They asked us to carry back a message to Washington: Put partisanship aside and end federal uncertainty about support for the ACA; otherwise, they will end up setting premiums higher than necessary or withdrawing from markets across the country. (Bill Frist and Andy Slavitt, 9/11)
Time is rapidly running out before health insurers have to commit to the policies and premiums they鈥檒l offer next year to roughly 20 million Americans not covered by an employer-sponsored health plan. Although those premiums are expected to jump 10% or more in many states, Congress can rein in that increase significantly 鈥 if it acts quickly. Doing so, however, will require Senate Republicans to stop flirting with yet another partisan proposal to 鈥渞epeal and replace鈥 the Affordable Care Act, and start focusing instead on steps to make coverage more affordable that can win broad support. (9/12)
The wager was large and lost. The attempt to revive a health-care alternative in the Senate seems halfhearted and doomed by the same ideological dynamics that killed the legislation the first time. Republican enthusiasm for the Mexican border wall is limited by the fact that it is among the most wasteful, impractical and useless ideas ever spouted by an American president. And ambitious tax reform has been tabled in favor of a few tax cuts that are likely to reaffirm public impressions that the 鈥淧鈥 in GOP stands for 鈥減lutocracy.鈥 (Michael Gerson, 9/11)
Many Democrats giddy from their recent health policy successes are starting to reach enthusiastically for a mountaintop goal: establishing a single-payer system for all Americans. But they may want to learn the lessons of their opposition. Like 鈥渞epeal and replace,鈥 鈥渟ingle-payer鈥 is a broadly popular slogan that papers over intraparty disagreements and wrenching policy choices. Republicans fumbled multiple attempts to replace the Affordable Care Act this year. If the Democrats eventually wrested back power, they could find themselves similarly factionalized and stymied over the details. (Margot Sanger-Katz, 9/11)
Welcome to single-payer health care week. Bernie Sanders plans to introduce his Medicare for all bill this week, and it鈥檚 already winning support from some Democrats. Even Max Baucus, the powerful former Montana senator who long opposed single-payer, now supports it. With Republicans controlling every branch of government, single-payer health care has no chance of becoming law anytime soon. But the attention to it still matters. The odds are rising that Democrats will make a push toward single-payer when they next are in charge. (David Leonhardt, 9/11)
Viewpoints: Bracing For Health Data Breaches; The Economics Of Opioid Abuse And Despair
Just a couple of weeks ago, NHS Lanarkshire, the third largest health system in Scotland and one that employs over 12,000 staff, fell victim to a malware attack. On the heels of a broad cyberattack affecting much of the National Health Service (NH) in May, medical operations were put on hold, and patients were even told to not go to the hospital unless it was absolutely necessary. Though occurring on the other side of the Atlantic, this event stood as a stark reminder that many hospitals, health systems and other companies in the health care space are vulnerable to a cyberattack. (Cori McKeever Ashford and Kristen Thistle, 9/12)
Anne Case and Angus Deaton's 2015 article on rising mortality among middle-aged white Americans -- and the 2017 follow-up that attributed this rise to an increase in suicides, drug overdoses and alcohol-related deaths among those without college educations -- was among those rare academic papers that changed public debate. (Justin Fox, 9/11)
Health care and social workers, counselors, and law enforcement agencies, as well as policy makers and administrators at the local, state, and federal levels of government are already putting it all on the line to help people overcome addiction. We must give them the tools and support they need so we can win this fight. (Sen. Elizabeth Warren, 9/11)
The theory has gained such prominence that a United States senator is investigating it. 鈥淢edicaid expansion may be fueling the opioid epidemic in communities across the country,鈥 Senator Ron Johnson, Republican of Wisconsin, wrote recently. Some conservative opponents of the Affordable Care Act have been passing around the same theory for months. It鈥檚 a politically explosive (and convenient) argument, but is it true? Substantial evidence suggests the answer is no, but let鈥檚 give it a fair hearing. (Aaron E. Carroll and Austin Frakt, 9/12)
Don鈥檛 be fooled when pharmaceutical companies argue that their pricing strategy is simply based on supply and demand. We all know that is not true. It鈥檚 time that Ohioans demand pharmaceutical companies bring down their outrageously overpriced drugs. (Nina Turner, 9/11)
I was first diagnosed with cancer when I was a senior in college, preparing to get a job and begin paying off my student loans. I was fortunate to have school administrators who advocated for me, and my loans were quickly deferred. But many of the 70,000 young adults diagnosed with cancer each year in the United States aren鈥檛 so lucky. They continue to rack up interest as they put their lives on hold to go through lifesaving cancer treatments. That鈥檚 why I urge Congress to pass the Deferment for Active Cancer Treatment Act of 2017 this session. This essential but under-the-radar piece of legislation would allow cancer patients to qualify under existing laws for student loan deferments while they undergo treatment. (Samantha Watson, 9/11)