First Edition: August 12, 2014

Today's headlines include stories about how the federal government's experience with healthcare.gov has led to the creation of the U.S. Digital Service.

Kaiser Health News: Must A Divorced Dad Cover Adult Kids; Will Medicare Pay For Infusion Therapy
Kaiser Health News consumer columnist Michelle Andrews explores questions related to a divorced mother's efforts to get her ex-husband to keep their sons on his plan, one senior's problems getting Medicare to cover his antibiotic infusion at home and what earnings one reader will have to count when applying for premium subsidies (Andrews, 8/12). Read her responses.

Kaiser Health News: To Beat Heroin Addiction, A Turn To Coaches
WBUR's Martha Bebinger, working in partnership with Kaiser Health News and NPR, reports: "Two young men sit in a car outside a church or union hall where they just attended a Narcotics Anonymous meeting. Both men are addicted to heroin. But they haven't used the drug since they finished a residential treatment program a week or so earlier. … Of patients addicted to heroin who stop, 40 to 60 percent relapse within the first year. For many it happens soon after finishing a recovery program. Wurzberg is now in a new young adult recovery program. It's a one-year pilot project at Gosnold, which runs a network of addiction treatment services on Cape Cod" (Bebinger, 8/11). Read the story.

Kaiser Health News: Stigma Is A Side-Effect Of HIV-Prevention Medicine
WABE's Jim Burress, working in partnership with Kaiser Health News and NPR, reports: "In order to slow the spread of HIV, certain people who do not have the virus but are at risk should take medication to prevent becoming infected. That's the recommendation of the Centers for Disease Control and Prevention, and just recently, the World Health Organization. The preventive treatment includes a drug called Truvada, and it is known as PrEP, for pre-exposure prophylaxis" (Burress, 8/11). Read the story.

The New York Times: White House Picks Engineer From Google To Fix Sites
Faced with the politically devastating collapse of HealthCare.gov last year, President Obama's White House staff lured Mikey Dickerson away from Google to save the day. Mr. Dickerson will lead a new government team that is intended to identify and fix the government's other failing computer systems and websites, officials said Monday (Shear, 8/11).

The Washington Post: White House Launches 'U.S. Digital Service,' With Healthcare.Gov Fixer At The Helm
The White House on Monday announced that it is formally launching a new U.S. Digital Service and that it has hired to lead it Mikey Dickerson, an engineer widely credited with playing a central role in salvaging HealthCare.gov after its disastrous launch. The idea behind the USDS, as the White House has taken to calling it, is institutionalizing the approach that saved the health care site and applying it to the work of the government even before disaster strikes (Scola, 8/11).

The Wall Street Journal's CIO Journal: White House Proves It Can Lure Top Tech Talent
It took a nearly $1 billion IT disaster in the implementation of HealthCare.gov to shake up the government's approach to hiring tech staff, but the federal government is finally starting to attract Silicon Valley leadership. The White House Monday hired former Google Inc. engineer Mikey Dickerson, who helped fix the troubled federal health insurance exchange, to run the new U.S. Digital Service charged with preventing future government IT fiascoes, the Washington Post reports. That the White House managed to land a seasoned engineer from one of the world's leading tech companies is as much a surprise as it is a coup. Top technology talent usually is reluctant to work for the government, John Challenger, CEO of professional staffing firm Challenger Gray & Christmas Inc. told CIO Journal in January. Not only is the pay often lower, but government work can be too bureaucratic and process-centric for people used to Silicon Valley's coding culture. "We need much better tech workers in government but I just don't think you can get there from here," said Mr. Challenge (Boulton, 8/11).

Politico: Consumers' Next Obamacare Challenge: Tax Forms
If consumers thought logging on to HealthCare.gov was a headache, sorting through complex forms ahead of tax deadline day 2015 is their next big Obamacare challenge. The health care law's benefits are rolling out, but its major math problems start next year as the IRS tries to ensure that millions of Americans are correctly calculating their benefits and that those who don't have coverage are penalized unless they qualify for an exemption (Cunningham and Weinger, 8/11).

Los Angeles Times: Kaiser Cuts Obamacare Rates 1.4% For 2015; Anthem Hikes Rates 4.6%
Healthcare giant Kaiser Permanente is lowering its rates for Obamacare coverage in California by 1.4% next year, according to an industry report. California's health insurance exchange recently announced that premiums were rising 4.2%, on average, statewide for 2015 policies. A new analysis by Citigroup healthcare analyst Carl McDonald offers new details on what consumers can expect by company (Terhune, 8/11).

The Washington Post's Wonkblog: Another Argument Against The Medicaid Expansion Just Got Weaker
We learned late last week that the decision by 24 states to reject Obamacare's Medicaid expansion comes as a startling cost -;$423.6 billion in lost federal funds from 2013 to 2022, according to researchers at the Urban Institute. So how are states justifying their decisions to leave that much federal money on the table? One of their main arguments is that the federal government will eventually renege on its generous funding commitment to the Medicaid expansion. But based on the 49-year history of the Medicaid program, that claim doesn't hold up, according to Urban Institute researchers in a finding that hasn't received as much attention (Millman, 8/11).

The New York Times: Postal Service Quarterly Loss Was $2 Billion, Despite Higher Prices
Despite an increase in revenue for nearly all of the Postal Service's products, the agency continues to be mired in debt because of a congressional requirement to pay about $5 billion into a future retiree health care fund, post office officials said on Monday (Nixon, 8/11).

The Wall Street Journal: U.S. Postal Service Posts $1.96 Billion Loss In Third Quarter
The biggest financial hurdle is a congressional mandate that requires it to prefund about $5.5 billion annually for health benefits for future retirees. The service said Monday it will default on its required $5.7 billion payment by Sept. 30 for the fourth year in a row, unless legislative reform is passed in time. Before this charge, as well as some workers' compensation items, it would have earned $1 billion in the first three quarters (Stevens, 8/11).

The New York Times: On Supreme Court, Does 9-0 Add Up To More Than 5-4?
The court was unanimous in striking down buffer zones near abortion clinics in Massachusetts and was divided 5 to 4 in saying some employers could refuse to provide contraception coverage. The different vote counts did not seem to figure in the reactions of women's groups opposed to the rulings. Michael F. Salamone, a political scientist at Washington State University, has designed experiments to test whether the public is more apt to accept unanimous decisions than divided ones (Liptak, 8/11).

The Wall Street Journal: FDA Approves DNA Test For Colon Cancer
The Food and Drug Administration on Monday approved a DNA test to screen for colon cancer in people with a lower risk of developing the disease, the first such test of its kind to be cleared by U.S. regulators. The test, called Cologuard, is used to detect genetic mutations in patients' stool associated with cancerous and precancerous growths in the colon. Doctors must prescribe the test, but patients collect stool samples at home and ship the samples to laboratories for analysis (Walker, 8/11).

The Wall Street Journal: Health Care At College: Can Your Teen Manage?
What could go wrong did go wrong for Leah Davies in 2011. Having turned 18, a legal adult when it comes to care providers sharing health information with parents, mom and dad were forced to the sidelines as doctors at home tried to convince the hospital in Syracuse to be more aggressive. Heading off to school is stressful for young people on a variety of fronts. Among the biggest challenges is managing their own health far from home. And it can be a trial for parents, too, in this, the era of the helicopter when it comes to raising children (8/11).

The Washington Post's Morning Mix: How Colorado's Teen Birthrate Dropped 40% In Four Years
Since 2009, the state has provided 30,000 contraceptive implants or intrauterine devices (IUDs) at low or no cost to low-income women at 68 family-planning clinics across Colorado through the Colorado Family Planning Initiative. The effort was funded by a five-year commitment of $23 million from an anonymous donor (Sullivan, 8/12).

The Washington Post: McAuliffe Sets Up Boards To Address Children's Issues In Virginia.
A program of the cabinet called the Commonwealth Council on Childhood Success will have a more narrow mission: improving access to pre-kindergarten, education, nutrition and health care from birth to third grade. It will be led by Lt. Gov. Ralph Northam (D), who is a full-time pediatric neurologist in Norfolk (Portnoy, 8/11).