Customized Briefing for Brett Houston
From NAHU
Leading the News
Legislation and Policy
Public Health and Private Healthcare Systems
Senior Market News
December 14, 2010
Also in the News
Leading the News
Federal Judge Rules Insurance Mandate In Healthcare Law Unconstitutional.
Media reports, including stories on all three network newscasts, depicted yesterday's court ruling on the healthcare reform law as a serious
political blow for the Administration. While a number of analyses point out that the legal battle will -- as expected all along -- be decided by
the Supreme Court, they also indicate that a high-profile political debate on the law -- which continues to be described as unpopular -- is
not in the Administration's best interests.
The New York Times (12/14, A24, Stolberg) reports, "By the numbers, President Obama is beating opponents of his signature health
care bill two to one in federal court. Of the three district court judges who have ruled on the merits of constitutional challenges to the
landmark Affordable Care Act, two have sided with Mr. Obama." However, "from a political standpoint, the only case that really matters is
the one Mr. Obama lost on Monday," and "Judge Henry E. Hudson's decision leaves the White House playing defense for the foreseeable
future on an issue it once thought would secure Mr. Obama's legacy," providing "another rallying point for conservatives as they make the
case that government is overreaching and must be reined in."
ABC World News (12/13, story 3, 2:30, Sawyer) referred to a "major legal blow" to "the historic healthcare reform law." ABC (Tapper)
noted that "the healthcare bill that...Obama signed into law in March requires that every American who can afford it buys health insurance,"
and on Monday "Hudson...called that requirement 'unconstitutional.' What's called an individual mandate, he said, 'exceeds the
constitutional boundaries of Congressional power."
The CBS Evening News (12/13, story 4, 2:25, Crawford) reported, "The White House hailed it as a once-in-a-generation reform," but
"in a 42-page ruling Monday, a Federal judge in Virginia had another word for the landmark health care legislation: unconstitutional." NBC
Nightly News (12/13, story 4, 1:35, Williams) called the ruling "a pointed reminder that the battle over healthcare is far from over." NBC (P.
Williams) added that "while this doesn't stop the law for now, it does tee up a mammoth legal battle to come." The judge "endorsed the
claim made by conservatives and Tea Party groups nationwide, that Congress did not have the power to pass the Obama health care law.
It's a victory for the state of Virginia, which argued that the heart of the law requiring everyone to buy insurance was unconstitutional."
The AP (12/14, Sherman, Werner) reports that Obama's "historic health care overhaul" was "thrown into doubt by a federal judge's
declaration that the heart of the sweeping legislation is unconstitutional," in a ruling that "handed Republican foes ammunition for their
repeal effort." USA Today (12/14, Wolf, Biskupic) also reports that the ruling "boosted efforts by opponents who want it repealed, stripped
of funding or struck down by the US Supreme Court, a battle that could take years."
The New York Times (12/14, A1, Sack) reports on its front page, "Thus far, judges appointed by Republican presidents have ruled
consistently against the Obama administration while Democratic appointees have found for it." And "that has reinforced the notion -- fueled
by the White House -- that the lawsuits are as much a political assault as a constitutional one."
The Washington Post (12/14, Aizenman) reports that for the Supreme Court, "the issue comes before a court evenly divided between
liberals and conservatives, with moderate conservative Justice Anthony M. Kennedy often holding the deciding vote. So how might the
justices rule? Both sides can point to precedents that bolster and hurt their chances on two key questions." Bloomberg News (12/14,
Schoenberg, Fisk), the Washington Times (12/14, Seper), the Wall Street Journal (12/14, Adamy, subscription required), the Washington
Post (12/14, Klein), The Hill (12/14, Millman) Healthwatch blog, The Atlantic (12/14, Good), the Boston Herald (12/14, Chabot, McConville),
the NPR (12/14, Memmott) The Two-Way blog, the CNN (12/14, Mears) AC360 blog, the CNN (12/14) The Chart blog, the Forbes (12/14,
Van Horn) Second Opinion blog, the New Republic (12/14, Chait), the Baltimore Sun (12/14, Cohn) Picture of Health blog, and the Time
(12/14, Pickert) Swampland blog also report on the ruling.
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Legislation and Policy
Lawmakers To Seek Repeal Of Small Business Tax-Reporting Provision Next Year.
CQ Today (12/14, Ethridge, subscription required) reports, "Although both Democrats and Republicans have pledged to repeal an
unpopular tax-reporting requirement in the health care overhaul, members acknowledge they have run out of time to reach an agreement
this year." Still, "lawmakers on both sides say they will return to efforts to abolish the requirement soon after Congress reconvenes next
month." The lawmakers proposed "amendments in November to repeal the provision, which requires businesses to file a 1099 form with
the IRS for every vendor they pay more than $600 to in a year."
Surveys: Americans Still Disagree About Healthcare Law.
CQ HealthBeat (12/14, Adams, subscription required) reports, "Nearly nine months after its passage, the health care law still remains
controversial, according to two new polls released Monday that show the public is torn in their views of the measure." Notably, "support for
the law is down to 43 percent of respondents in the ABC News/Washington Post poll, which is one percentage point lower than any
previous result since the groups began polling on that issue in 2009. Fifty-two percent of those surveyed oppose the overhaul measure."
CQ adds, "When asked what Congress should do about the law, about 29 percent said that lawmakers should repeal all of it and 30
percent favor repealing some parts." Overall, the "public's views have not changed significantly over time," and Kaiser Foundation survey
had similar results.
Public Health and Private Healthcare Systems
Over 98 Percent Of Massachusetts Residents Now Have Health Insurance.
The AP (12/14) reports, "More than 98 percent of Massachusetts residents now have health insurance of some kind." A new report "by
Gov. Deval Patrick's (D) administration found that 98.1 percent of state residents were covered during a survey between May and June."
All told, "only about 120,000 people now lack either private or government-paid insurance in Massachusetts."
UnitedHealthcare Adds More Retailers To Medicare Plan Pharmacy Program.
The Tampa Bay (FL) Business Journal (12/14) reports that UnitedHealthcare announced it has "added additional retailers to its recently
launched Pharmacy Saver program" for Medicare plan members. "Target Corp., H-E-B, Hy-Vee Inc., Publix Super Markets Inc., Food Lion,
Bloom, Harveys, and Sweetbay Supermarket" are joining Pharmacy Saver. The move will "double the number of locations" where
UnitedHealthcare members can "access 30-day supplies of select prescriptions for only $2."
Groups Issue Recommendations About How To Manage Care For "Dual Eligibles."
The Hill (12/14, Millman) reports in its Healthwatch blog, "Liberal groups issued policy recommendations Monday morning on how to
manage care for a typically costly population of so-called 'dual eligibles' -- people who qualify for both Medicare and Medicaid." Due to
"generally poorer health and greater needs for high-cost services, the country's 8.8 million dual eligibles are the most expensive population
within the Medicare and Medicaid programs and the most difficult to coordinate care for, according to a report issued Monday morning by
the Center for American Progress and Community Catalyst." Data show that "dual eligibles make up 18 percent of Medicaid enrollees but
consume 46 percent of program spending. Meanwhile, they comprise 16 percent of Medicare enrollees but consume 25 percent of
spending."
Medicare Physician Payment Still A Problem Congress Must Tackle In 2011.
The Atlanta Journal-Constitution (12/14, Teegardin) reports that more and more physicians are informing seniors that they will "no longer
accept Medicare." Notably, "Congress avoided an exodus of doctors from the Medicare program last week when it pushed back a 25
percent cut in physician payments that was set for January," yet "doctors will face an even larger cut in payments this time next year
unless Congress redesigns the dysfunctional system that adjusts Medicare rates." The paper adds, "The Congressional Budget Office
estimates that it would cost an additional $275 billion to keep physician payments at their current levels through 2020. So far, no one can
figure out where that money would come from."
Pilot Program Has Saved Medicare About $100 Million.
The Denver Post (12/13, Booth) reported, "A northwest Denver pilot program to prevent expensive hospital returns for relapsed patients
has gone nationwide and is demonstrating hundreds of millions of dollars in potential Medicare savings, according to preliminary results."
Notably, "the 14-city demonstration has already saved an estimated $100 million in Medicare spending on hospitals, among about 1.25
million enrollees." These "cities are a year and a half into the demonstration, which links elderly hospital patients with transition coaches
who help them coordinate drugs, doctor follow-ups and home health care aids to prevent pricey and dangerous hospital readmissions." So
far, "the Denver program shows a 9.3 percent cut in readmissions among 80,000 Medicare patients in the study group, which covers 44
ZIP codes."
Medicaid Cuts Force States To Eliminate Some Services.
The AP (12/14) reports, "Across the country, state lawmakers have taken harsh actions to try to rein in the budget-busting costs of the
health care program that serves 58 million poor and disabled Americans." Some states have been forced to "cut payments to doctors, paid
bills late and trimmed benefits such as insulin pumps, obesity surgery and hospice care." Now, "some states face multibillion-dollar deficits.
Federal stimulus money for Medicaid is soon to evaporate. And Medicaid enrollment has never been higher because of job losses."
Senior Market News
Some Seniors To Pay Higher Medicare Costs Due To Healthcare Law.
CQ HealthBeat (12/14, Adams, subscription required) reports, "The percentage of Medicare seniors who will have to pay a higher premium
for Part B outpatient services will increase from about 5 percent in 2011 to 14 percent in 2019 because of changes put in place by the
health care law that base beneficiaries' premiums on their incomes, according to a new analysis for the nonpartisan Kaiser Family
Foundation." In addition, "higher-income seniors...will have to pay higher fees for their drug coverage for the first time, with about 3 percent
of enrollees in 2011 and 9 percent in 2019 facing the higher costs." CQ notes, "The law also will begin to tie Part D drug costs for seniors
to their incomes for the first time."
Consumers Find Most Long-Term Care Policies Expensive.
The Washington Post /Kaiser Health News (12/14, Andrews) reports, "People don't like to think about what will happen if they become too
ill or infirm to manage on their own," and "experts say that partly explains why sales of long-term-care insurance policies are so anemic;
only about 10 percent of seniors have such coverage." Due to "the complexity of these policies, experts agree it's tough to decide whether
they're right for you," and "they also tend to have high premiums," for instance, "a 60-year-old might pay $200 a month for a policy that
pays $150 a day for a maximum of three years." At present, "government programs aren't much help to middle-income people," but "in the
future, people may be able to take advantage of the Community Living Assistance Services and Support Act, or CLASS Act," which is part
of "the new health-care law."
Minnesota Reportedly Faces "Unsustainable Burden" For Long-Term Care.
The Minneapolis Star Tribune (12/14, Wolfe) reports, "Minnesota faces an 'unsustainable burden' on taxpayers for nursing homes and
other long-term care as the population ages, but it can significantly lower those costs by making it easier and more attractive for people to
invest in their own care, a new report from the Citizens League says." The report "recommends revamping the federal-state Medicaid
program -- which it says now encourages people not to save for their care -- and adding new products to help people use home equity or
savings to pay for long-term care." Otherwise, "as the older population doubles and health care costs continue rising, the government cost
of long-term care in Minnesota will soar from about $1.1 billion this year to $5 billion by 2035, the report says."
Also in the News
Fragmentation Of Medical Information Persists In Adult Acute-Care Settings, Resulting In
Higher Costs.
Modern Healthcare (12/13, McKinney, subscription required) reported, "Fragmentation of medical information persists in adult acute-care
settings, resulting in higher medical costs and increased likelihood of adverse events," according to data in the Archives of Internal
Medicine. "The number of sites that some patients went to for acute care astonished us," lead investigator Kenneth Mandl, MD, MPH said.
The Harvard Medical School associate professor added, "For the first time we showed just how common it is to go across sites of care,
and now understanding this, we can look at the issue of information fragmentation and demonstrate the critical value of making vital health
information accessible across settings."
Delving into study specifics, Kaiser Health News (12/13, Parashar) reported that investigators "looked at 3.5 million adults who made
12.7 million visits to emergency" departments in Massachusetts between 2002 and 2007. They found that "nearly one in three
Massachusetts adults with multiple ED trips visited separate hospitals -- some upwards of five -- creating a host of dangerous and costly
problems because full health information is not always shared between hospitals." And, "people with psychiatric disorders and dementia
are especially at risk of error or unnecessary treatment because they can't always accurately convey what previous care they've had."
Notably, "patients who visited more than two different sites racked up nearly twice the bill ($12,050 on average) compared with patients
who went to the same sites ($7,465)."
Higher Prescription Co-Payments Linked To Discontinuation Or Incomplete Use Of LifeSaving Breast Cancer Therapy.
The Milwaukee Journal Sentinel (12/13, Johnson) "Health & Science Today" blog reported, "A new study found that higher prescription copayments appear linked to the discontinuation or incomplete use of a life-saving breast cancer therapy, especially among older women."
Before reaching those conclusions, Columbia University researchers looked at data on "8,110 women ages 50 to 65 and 14,050 women
older than 65." They eventually found that "women 65 and older were more likely to discontinue the medication if their co-payments were
more than $30." However, "co-payments needed to reach $90 or more before women under age 65 became more likely to discontinue use
or fail to take the treatment as prescribed."
Physician Groups Seek $200 Million In Overdue Medicare Reimbursements.
The Hill (12/13, Millman) "Healthwatch" blog reported, "Doctors are asking the Medicare agency to quickly explain how it will dole out $200
million in overdue reimbursements following 'highly disruptive year' for physician payments." The Hill said "healthcare reform enacted this
year called on the" CMS "to reimburse doctors retroactively to Jan. 1, 2010, on several provisions, including extending the floor for a
Medicare payment scale used to determine relative costs of practicing medicine in specific locations." Notably, "some states were set to
receive significant increases due to changes in the scale, according to the Friday letter signed by more than 100 physicians groups."
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