First Edition: July 30, 2014

Today's headlines include a range of health policy headines, including news from Capitol Hill on the Senate confirmation of Robert McDonald to head the VA.

Kaiser Health News: Expert Panel Recommends Sweeping Changes To Doctor Training System
Kaiser Health News staff writer Julie Rovner reports: "An expert panel recommended Tuesday completely overhauling the way government pays for the training of doctors, saying the current $15 billion system is failing to produce the medical workforce the nation need" (Rovner, 7/29). Read the story.

Kaiser Health News: California Makes Significant Progress In Enrolling Previously Uninsured, Survey Finds
Kaiser Health News staff writer Anna Gorman reports: "A significant portion of previously uninsured Californians gained medical coverage through the nation's health care law – about six in 10 during the state's first open enrollment, according to a survey released Wednesday. All told, about 3.4 million people who didn't have health insurance before sign-ups began last fall are now covered, according to the survey by the Kaiser Family Foundation" (Gorman, 7/30). Read the story.

Kaiser Health News: As Ballet Stretches Her Body's Limits, Insurance Brings Peace of Mind
Kaiser Health News staff writer Heidi de Marco reports: "The annual injury rates at ballet companies run between 67 and 95 percent, according to a study by the American Journal of Sports Medicine. But ballerinas and their male counterparts often dance through the pain. … Despite her tough-it-out training, she'd prefer to have insurance. So by the time the Affordable Care Act took effect, allowing her ballet company to buy a plan, Noelle was eager to sign up" (de Marco, 7/20). Read the story or watch the related video, also by de Marco.

Kaiser Health News: Capsules: Survey Finds 1 In 5 Uninsured Don't Want Coverage; Moving Children From CHIP To Exchange Plans Would Increase Costs: Study; Rx For Clarity: Calif. Considers Bilingual Drug Labels
Now on Kaiser Health News' blog, Phil Galewitz reports on a new survey regarding the uninsured: "Though millions of people gained health coverage this year as a result of the Affordable Care Act, millions more remain unaware of their options or have no interest in getting insured, a new survey has found" (Galewitz, 7/30). 

In addition, Mary Agnes Carey reports on a study regarding CHIP and Medicaid coverage for kids: "Cost sharing would increase and the number of child-specific services covered would decline if millions of low-income children now enrolled in the Children's Health Insurance Program (CHIP) were forced to receive coverage through the health law's insurance exchanges, according to a study released Tuesday" (Carey, 7/29). 

Also on the blog, KQED's April Dembosky reports on a move toward bilingual drug labels in California: "This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. New York approved a similar rule last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes" (Dembosky, 7/30). Check out what else is on the blog.

The New York Times: More Californians Sign Up For Health Plans, Survey Says, But Holdouts May Be Hard To Get
While a new survey of the uninsured in California shows that nearly six out of 10 people were able to obtain coverage in the last year, the findings offer fresh insight into just how difficult it may be to sign up the people who remain uninsured, even after the introduction of the new state marketplaces (Abelson, 7/30).

Los Angeles Times: Number Of Californians Without Health Insurance Drops Sharply
A Kaiser Family Foundation survey examining the state's progress under the federal medical care overhaul said more than 80% of those still uninsured hadn't had coverage in two or more years, including 37% who reported never having coverage before. Foundation Chief Executive and President Drew Altman said though large numbers of Californians gained insurance during the first open enrollment period, "expanding coverage gets harder from here" (Karlamangla, 7/29).

The Associated Press: Hawaii Health Care Faces Federal Threat
The problem starts with the Hawaii Health Connector, a federally mandated insurance marketplace that's losing money. A temporary funding plan went into effect this month, but once that money runs out, lawmakers will need to settle on a long-term fix that officials characterize as a choice between propping up a failing system at the expense of taxpayers, or turning control over to federal authorities at the risk of unravelling the state's comprehensive Prepaid Health Care Act (7/29).

The Associated Press: Appeals Court Rejects Tax Challenge To Obamacare
Rejecting the latest effort to sidetrack "Obamacare," a federal appeals court turned away a challenge by a conservative group that said Congress imposed new taxes unconstitutionally when it created the Affordable Care Act. Pacific Legal Foundation and a small-business owner, Matt Sissel, argued that the Affordable Care Act is a bill for raising revenue and that it violated the Origination Clause of the Constitution because it began in the Senate, not the House. The Constitution requires that legislation to raise revenue must start in the House (7/29).

Politico: Court Throws Out An Obamacare Tax Law Challenge
Obamacare watchers broadly expected the suit to fail, although its profile was raised this spring after the Washington Post's George Will wrote a column saying it would doom Obamacare (Norman, 7/29).

The Washington Post: Obama To Lash Out At Republicans Over 'Stunt'
President Obama will lash out at House Republicans on Wednesday for their plans to sue him over his use of executive authority, the White House said, in what appears to be part of a burgeoning effort to highlight what Democrats see as outlandish acts by Republicans in an election-year. The White House and Democratic candidates have been showering attention on the potential lawsuit by House Republicans and chitchat in Washington over potential impeachment proceedings as a way to portray the GOP as out-of-touch with the concerns of ordinary voters and infatuated with political theatrics (Goldfarb, 7/30).

The New York Times: Senate Confirms Obama's Choice To Lead V.A.
The Senate voted unanimously on Tuesday to confirm Robert A. McDonald, the 61-year-old former chief executive of Procter & Gamble, to take the helm of the sprawling and embattled Department of Veterans Affairs after a scandal over the manipulation of patient wait-time data led to the ouster two months ago of Eric Shinseki (Oppel Jr., 7/29).

The Wall Street Journal: Senate Confirms McDonald As VA Secretary
The Senate confirmed Robert McDonald to head the Department of Veterans Affairs on Tuesday, one day after congressional leaders cobbled together a $17 billion funding bill to help reform the agency and expand care. Mr. McDonald takes over as VA secretary after little debate or opposition and a 97-0 confirmation vote on the Senate floor. Last week, he faced a friendly hearing before the Committee on Veterans' Affairs where he fielded few questions and was lauded by many on the panel (Kesling, 7/29).

The Washington Post: Senate Unanimously Confirms Robert McDonald As VA Secretary
Tuesday's vote represented a rare example of swift, bipartisan action by the Senate to address pressing problems. Obama nominated McDonald on June 30, and the Senate Veterans Affairs gave him a warm reception during his confirmation hearing last week (Hicks, 7/29).

Politico: Senate Approves Robert McDonald For VA
He'll take the post from acting VA Secretary Sloan Gibson, who was elevated in May when former secretary Eric Shinseki resigned over reports that the department was manipulating records to hide that veterans were at times waiting months to see doctors (French, 7/29).

The Associated Press: Bill To Overhaul VA Heads To Full House, Senate
House and Senate negotiators have approved a $17 billion compromise bill to overhaul the Department of Veterans Affairs. The vote by the 28-member conference committee late Monday sends the bill to the full House and Senate, where approval is expected later this week. The bill is intended to help veterans avoid long waits for health care, hire more doctors and nurses to treat them, and make it easier to fire executives at the VA (7/19).

USA Today: VA Manipulated Vets' Appointment Data, Audit Finds
Internal VA documents show the depth of fraudulent scheduling, manipulation of data and in some cases intimidation of staff to hide delays in medical care to veterans in the 6-million patient national system. Auditors found at least one appointment scheduler at 109 VA medical centers who said wait times for veterans had been falsified, according to a USA TODAY analysis of internal VA survey data made public Tuesday. To keep evidence of delayed care out of the VA's official electronic tracking system, secret lists were maintained at 110 facilities, the analysis shows (Zoroya and Hoyer, 7/30).

The Wall Street Journal: WellPoint Profit Slips, But Boosts Outlook
Still, the company again raised its earnings outlook for the year, saying it now expects adjusted per-share profit to top $8.60, compared with its prior forecast for earnings of more than $8.40 a share. WellPoint reiterated its expectation for operating revenue above $73.5 billion. WellPoint in January said the people enrolling in new health-law plans were skewing older than its previous individual consumers, but they appeared to match the less-healthy pool the company predicted when it set its prices (Prior, 7/30).

The Wall Street Journal: Benefit Costs Pare Humana's Profit
Earnings met analysts' expectations, but the top line exceeded them. Humana said its profit declined, as expected, because of its investments in health care exchanges and state-based contracts, while higher costs associated with specialty hepatitis C treatments also weighed on results (Calia, 7/30).

The Wall Street Journal: HCA Holdings Profit Rises 14%
In a recent preview of its second-quarter results, HCA had said admissions to its hospitals rebounded and that greater-than-expected benefits from the health-care reform law contributed to the company's performance. At the time, HCA also raised its estimate of the Affordable Care Act's benefit to adjusted earnings this year by one percentage point, from to 2% to 3%. HCA Holdings reported a profit of $483 million, or $1.07 a share, up from $423 million, or 91 cents a share, a year earlier. Excluding debt-retirement losses and other items, adjusted earnings were $1.37 a share. Revenue increased 9.2% to $9.23 billion (Stynes, 7/29).

The Associated Press: $1,000 Sovaldi Now Hepatitis Treatment Of Choice
Even with insurers reluctant to pay, Sovaldi prescriptions have eclipsed those for all other hepatitis C pills combined in a matter of months, new data from IMS Health indicate. The promise of a real cure, with fewer nasty side effects, has prompted thousands to get treated. But clinical and commercial successes are also triggering scrutiny for the drug's manufacturer, California-based Gilead Sciences Inc., which just reported second-quarter profits of $3.66 billion, or a net margin of 56 percent. Two senators have unearthed documents that suggest the initial developers of Sovaldi considered pricing it at less than half as much. The health insurance industry is publicly scolding Gilead, and state Medicaid programs are pushing back (7/29).

The Washington Post's Wonkblog: The U.S. Spends $15B A Year To Train Doctors, But We Don't Know What We Get In Return
If you were spending $15 billion, you'd probably want to know what you were getting as a return on that investment. Especially if it was on something as important as the nation's health care. Yet, a new comprehensive report finds that we don't have a good system of tracking the $15 billion the United States spends each year on training new doctors -; a particularly pressing topic as 11,000 baby boomers become Medicare-eligible each day and about 25 million uninsured are projected to gain new coverage in the next few years under the Affordable Care Act. Further, our publicly financed program for training doctors doesn't ensure that the new crop of physicians will be positioned to meet changing demands for care, according to independent experts at the Institute of Medicine (Millman, 7/29).

The New York Times: The D.O. Is In Now
Inside, Touro seems indistinguishable from a conventional medical school -; what doctors of osteopathic medicine, or D.O.s, call allopathic, a term that some M.D.s aren't much fond of. A walk through the corridors finds students practicing skills on mannequins hard-wired with faulty hearts. They dissect cadavers. They bend over lab tables, working with professors on their research. And, unlike their allopathic counterparts, they spend roughly five hours a week being instructed in the century-old techniques of osteopathic medicine, manipulating the spine, muscles and bones in diagnosis and treatment (Berger, 7/29).

Los Angeles Times: Health Premiums Soared, Insurance Commissioner Dave Jones Says
The cost of health insurance for individuals skyrocketed this year in California, with some paying almost twice what they did last year, the state's insurance commissioner said. But Insurance Commissioner Dave Jones predicted that insurers will ease up in the coming year to prevent California voters from approving tough new rate controls on the November statewide ballot as Proposition 45 (Pfeifer, 7/29).

The Wall Street Journal: FedEx Pleads Not Guilty To Illegal Drug Deliveries
In an indictment filed earlier this month, federal prosecutors said that beginning in 2004 the company repeatedly ignored warnings from the government that it was breaking the law by shipping drugs ordered from online pharmacies by people who had filled out online questionnaires. Among the charges in the indictment are conspiracy to distribute controlled substances, conspiracy to distribute misbranded drugs, distribution of controlled substances and misbranding of drugs. FedEx said it would fight those charges, as well as any others that may be brought (Stevens, 7/29).

The Wall Street Journal: Federal Court Blocks Mississippi Law Threatening Abortion Clinic
A federal appeals court on Tuesday blocked a Mississippi abortion law from taking effect, a ruling that appears to conflict with a decision earlier this year by the same court. Combined with other legal challenges of similar state laws, the move could set the stage for the Supreme Court to revisit the issue of abortion rights, legal experts said (McWhirter, 7/29).

NPR: Court Rejects Law Threatening Mississippi's Last Abortion Clinic
A federal appeals court has rejected a Mississippi law that would have forced the state's only abortion clinic to close. In a 2-1 decision, a panel of the 5th U.S. Circuit Court of Appeals on Tuesday turned aside arguments that women seeking to have an abortion could have the procedure done in a neighboring state (Greenblatt, 7/29).

Politico: Ruling Keeps Mississippi's Only Abortion Clinic Open
Mississippi's only remaining abortion clinic will stay open following a federal appeals court ruling Tuesday against a state law that requires abortion providers to have admitting privileges at a local hospital. After doctors at the Jackson Women's Health Organization sought and were denied admitting privileges at seven area hospitals, the state notified the clinic that its license would be revoked. A three-judge panel of the U.S. Court of Appeals for the Fifth Circuit ruled that by forcing the facility to be closed, the law would impose an "undue burden" on a woman's right to seek an abortion in Mississippi (Winfield Cunningham, 7/29).

The New York Times: Judges Block Abortion Curb In Mississippi
By a 2-to-1 vote, the panel of the United States Court of Appeals for the Fifth Circuit ruled that by imposing a law that would effectively end abortion in the state, Mississippi would illegally shift its constitutional obligations to neighboring states. The ruling is the latest at a time when states, particularly in the South, are increasingly setting new restrictions that supporters say address safety issues and that critics say are intended to shut clinics (Robertson and Eckholm, 7/29).

The New York Times: De Blasio's Plans To Reduce Worker Health Costs Have A Carrot And A Stick
When Mayor Bill de Blasio announced his first labor agreements with New York City unions this spring, he was sharply criticized for granting long-awaited wage increases in exchange for promises of unspecified though sizable savings on health care expenses (Greenhouse and Stewart, 7/29).

The Wall Street Journal: State's $1.3 Billion Medicaid Problem
The federal government has demanded that New York state pay back nearly $1.3 billion in Medicaid money distributed in 2010, prompting a rebuke from Gov. Andrew Cuomo's administration and a promise to appeal the decision. At issue are the costs of caring for about 1,300 developmentally disabled people-;about $2 million per patient in 2013-;in nine state facilities from Staten Island to Rochester. New York's Medicaid program is among the nation's most expensive (Kravitz, 7/29).

Los Angeles Times: County Wants Plan Before Funding Ways To Divert Mentally Ill From Jail
The proposal -; suggested by Supervisor Mark Ridley-Thomas -; comes as the county is under federal pressure to improve treatment of mentally ill jail inmates and as it embarks on a $2-billion overhaul that includes a new Men's Central Jail centered