First Edition: November 27, 2012

Today's headlines include reports about how increasing the Medicare eligibility age and making other entitlement program changes are a part of the ongoing "fiscal cliff" discourse.

Kaiser Health News: New Prenatal Blood Tests Come With High Hopes And Some Questions
Reporting for Kaiser Health News, in collaboration with The Washington Post, Rita Rubin writes: "When Ramona Burton became pregnant with her second child this year, the 37-year-old Upper Marlboro woman knew that her age put her baby at an elevated risk for Down syndrome, even though screening with ultrasound and standard blood tests raised no warning flags" (Rubin, 11/26). Read the story.

Kaiser Health News: Effort To Curb Medicare Spending Begins With Crackdown On Hospital Readmissions
Kaiser Health News staff writer Jordan Rau, working in collaboration with The New York Times, reports: "After years of gently prodding hospitals to make sure discharged patients do not need to return, the federal government is now using its financial muscle to discourage readmissions. Medicare last month began levying financial penalties against 2,217 hospitals it says have had too many readmissions. Of those hospitals, 307 will receive the maximum punishment, a 1 percent reduction in Medicare's regular payments for every patient over the next year, federal records show" (Rau, 11/26). Read the story.

Kaiser Health News: Insuring Your Health: Medical Questions About Gun Ownership Come Under Scrutiny
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Should doctors be able to ask patients or patients' parents whether they own a gun? What about health insurers, employers or health-care officials implementing the federal health law? Can they ask about gun ownership? The issue is playing out in Florida, where a federal judge in July issued a permanent injunction against enforcement of a law that would have prohibited doctors from asking patients about gun ownership in many instances, saying the prohibition impinged on doctors' First Amendment right to speak with their patients about gun safety" (Andrews, 11/26). Read the column.

Kaiser Health News: In Juvenile Detention, Girls Face Health Care Designed For Boys
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Incarcerated girls like Jessica are "one of the most vulnerable and unfortunately invisible populations in the country," and up to 90 percent have experienced physical, sexual, or emotional abuse, according to Catherine Pierce, a senior advisor at the federal government's Office of Juvenile Justice and Delinquency Prevention. The health statistics are particularly grim: 41 percent of girls in detention have signs of vaginal injury consistent with sexual assault, up to a third have been or are currently pregnant, eight percent have had positive skin tests for tuberculosis and 30 percent need glasses but do not have them, according to research from the National Girls Health and Justice Institute" (Gold, 11/26). Read the story.

Kaiser Health News: The Best Medicine For Fixing The Modern Hospital
Reporting for Kaiser Health News, in collaboration with Fast Company, Russ Mitchell writes: "Now, health care reform is fundamentally changing the way hospitals are run, and with it the way they look. A combination of crushing costs, government edicts, and fierce competition for the millions of newly insured patients that will result from federal health-care legislation has put the patient front and center" (Mitchell, 11/26). Read the story.

Kaiser Health News: Capsules: Study: States Face Increased Medicaid Costs Even If They Don't Expand Program; Report: Coverage Of Smoking Cessation Treatments Is Spotty Despite Health Law
Now Kaiser Health News' blog, Phil Galewitz reports on a new study regarding states and Medicaid costs: "If state officials think they can escape a fiscal quagmire by refusing to expand Medicaid under the federal health law, they might want to reconsider" (Galewitz, 11/26).

Also on the blog, Ankita Rao reports on insurance coverage trends regarding smoking cessation: "In 2010, the Affordable Care Act required that all new private health insurance plans completely cover preventive services deemed effective by the United States Preventive Services Task Force. Several methods of halting tobacco use, the country's leading cause of preventable death, made the cut. Despite effective treatments, a report from the Georgetown University's Health Policy Institute found that confusing language and inconsistent coverage stood in the way of those trying to use such treatments to kick their habits" (Rao, 11/26). Check out what else is on the blog.

The Wall Street Journal: 'Cliff' Wranglers Weigh Medicare Age
The fiscal cliff has revived an old idea that long seemed unfeasible: gradually raising the Medicare eligibility age to 67 from 65. Proponents of the idea point out that the health-overhaul law makes it easier, beginning in 2014, for seniors to buy private insurance, by banning insurance denials based on pre-existing conditions. Opponents caution that the change could raise premiums for younger people who buy private plans alongside these seniors in the law's new marketplaces, and on large employers who would be required to cover seniors in company plans (Radnofsky, 11/26).

The New York Times: Efforts To Curb Social Spending Face Resistance
President Obama's re-election and Democratic gains in Congress were supposed to make it easier for the party to strike a deal with Republicans to resolve the year-end fiscal crisis by providing new leverage. But they could also make it harder as empowered Democrats, including some elected on liberal platforms, resist significant changes in entitlement programs like Social Security and Medicare (Pear, 11/26).

The Washington Post: On 'Fiscal Cliff,' Both Sides Lay Groundwork For Debate's Next Phase
Ahead of the Wednesday meeting, GOP aides noted that Bowles offered a debt-reduction plan last fall in line with Republican principles. That plan called for $800 billion in fresh revenue through an overhaul of the tax code and significant spending cuts, including major changes to Medicare and other federal health programs (Goldfarb and Montgomery, 11/26).

Los Angeles Times: Much Talk, Little Action On 'Fiscal Cliff' As Congress Returns
Congress returned to a lame-duck session with no signs of quick compromise to ease the nation's budget deadlock, and the White House rolled out a strategy Monday to marshal popular support for raising taxes on the wealthiest tier of income earners. … In the days since, however, talks have become "slow," according to one congressional aide. Republicans insist that new revenue must come from economic growth, which they believe would be produced by revamping the tax code to lower all tax brackets -; an approach Democrats reject as "fairy tale" economics. Democrats are unwilling to discuss cuts to Medicare, Medicaid or other government programs unless Republicans put upfront revenue on the table, aides said (Mascaro and Parsons, 11/27).

The Associated Press/Washington Post: GOP Senator Offers Plan To Avert 'Fiscal Cliff': Spending Cuts, Entitlement Curbs, Tax Hikes
A freshman GOP senator is jumping into the debate on how to avoid a "fiscal cliff" of tax hikes and automatic spending cuts, advocating a mix of tax increases with curbs on Social Security and Medicare benefits. Tennessee Sen. Bob Corker is circulating a 10-year, $4.5 trillion plan loaded with controversial proposals, including a less generous inflation adjustment for Social Security, and a gradual increase in the regular Social Security retirement age to 68 and the Medicare eligibility age to 67 (11/27).

The Wall Street Journal: Court Orders New Review Of Health Law
The Supreme Court told a federal-appeals court Monday to consider several lesser-known legal arguments against the national health-care law, in an order backed by the White House. The move came in a case brought by Liberty University, a Lynchburg, Va., college founded by the late Rev. Jerry Falwell, and observers said the challenge was unlikely to succeed (Bravin, 11/26).

Los Angeles Times: Liberty University Allowed To Argue Claims Against Healthcare Law
The Supreme Court rectified an oversight Monday and gave a Baptist university in Virginia a chance to argue in a lower court two claims that were not considered in June when the justices upheld President Obama's healthcare law. Lawyers for Liberty University say it is unconstitutional for the government to require large employers to provide health insurance to their full-time workers or pay a tax (Savage, 11/26).

The Associated Press/Washington Post: Supreme Court Orders New Look At Christian College's Health Care Challenge
The Supreme Court has revived a Christian college's challenge to President Barack Obama's healthcare overhaul, with the acquiescence of the Obama administration. The court on Monday ordered the federal appeals court in Richmond, Va., to consider the claim by Liberty University in Lynchburg, Va., that Obama's health care law violates the school's religious freedoms (11/26).

Politico: SCOTUS Orders Appeals Court To Hear Liberty University Health Care Lawsuit
The Supreme Court on Monday ordered the 4th Circuit Court of Appeals to examine the constitutionality of the health care reform law's employer requirements and mandatory coverage of contraceptives without a co-pay. The move could open the door for President Barack Obama's health law to be back in front of the Supreme Court late next year. But legal experts say there's no guarantee that the justices would actually take the case -; or that they'd strike down those pieces of the law if they did (Haberkorn and Smith, 11/27).

The New York Times: Justices Consider Definition Of Supervisor In Job Discrimination Case
The Supreme Court heard arguments on Monday about who counts as a supervisor under a federal employment discrimination law. The court also issued orders clearing the way for further challenges to aspects of President Obama's health care law and rejecting an appeal concerning the insanity defense (Liptak, 11/26).

The Associated Press/Washington Post: Report Says States Can Get More Than $9 From Feds For Every $1 They Spend To Expand Medicaid
States will receive more than $9 in federal money for every $1 they spend to cover low-income residents under President Barack Obama's health care law, according to a nonpartisan analysis released Monday. Expanding Medicaid to cover about 20 million more low-income people will cost over $1 trillion nationally from 2013 to 2022, said the joint report from the Kaiser Family Foundation and the Urban Institute (11/26).

The New York Times: A Study Of Home Help Finds Low Worker Pay
Nannies, caregivers and housecleaners earn a median wage of about $10 an hour, and few receive benefits like health insurance or paid sick days, according to the first-ever national statistical study of domestic workers, which is being released on Tuesday (Greenhouse, 11/26).

Los Angeles Times: UnitedHealth's Earnings Outlook Is Below Expectations
UnitedHealth Group Inc., the nation's largest health insurer, issued a weaker-than-expected 2013 profit outlook amid worries about economic growth and negotiations over federal spending. Ahead of its annual investor conference Tuesday, UnitedHealth said it expects earnings next year to be $5.25 to $5.50 a share. That's slightly below the average analyst estimate of $5.58 a share (Terhune, 11/27).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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