LePage won’t ‘lift a finger’ to set up Maine’s health insurance exchange
Posted Nov. 15, 2012, at 7:07 p.m.
AUGUSTA, Maine — Maine will let the federal government take the reins on setting up a mandated online health insurance market, according to comments Gov. Paul LePage made Thursday to a national news outlet.
States must decide whether to set up the markets, called exchanges, or let the federal government step in to do it for them. The exchanges, online markets where consumers can buy coverage beginning next October, are a key component of President Barack Obama’s health reform law that aims to widen coverage to 30 million people.
LePage told Bloomberg news Thursday that he has no plans to set up an exchange in Maine.
“I’m not lifting a finger,” he said in an interview with Bloomberg at a Republican Governors Association meeting in Las V
egas. “We’re not going to get involved. We’re going to let Mr. Obama do a federal exchange. It’s his bill.”
LePage’s comments came a day before a Friday deadline for states to notify the federal government if they want to run the exchanges themselves.
Described as “Travelocity for health insurance,” the exchanges are websites where small businesses and individuals who aren’t covered through their employer can shop for coverage. Enrollment will begin next October for plans that will take effect Jan. 1, 2014.
Consumers can also use the exchanges to determine if they qualify for subsidies to help pay for their insurance or if they’re eligible for Medicaid, the state-federal health insurance program for the poor.
LePage and many other Republican governors have been highly critical of the health reform law, called the Patient Protection and Affordable Care Act. In April, LePage returned a $5.8 million federal grant that would have helped Maine pay for setting up an exchange.
Republican state lawmakers had already hit the brakes on planning for an exchange to wait for the Supreme Court to rule on the health care law’s constitutionality. The law was largely upheld in June.
The Republican Governors Association on Wednesday asked the Obama administration for more time to decide on the health exchange provision. In a letter to the president, Virginia Gov. Bob McDonnell and Louisiana Gov. Bobby Jindal said governors don’t have enough information to assess the effect of the exchanges or to understand how the federal government will implement them.
Republican governors continue resisting implementing major provisions of the law — most of which will take effect in 2014 — in the wake of Mitt Romney’s defeat in the presidential election. Romney had vowed to repeal the health care overhaul. Critical of the law’s costs and regulatory burdens, some Republican lawmakers now hope to block federal funding for the exchanges.
States Decline to Set Up Exchanges for Insurance
By ROBERT PEAR and ABBY GOODNOUGH
WASHINGTON — Georgia, Ohio and Wisconsin joined more than a dozen other states on Friday in saying they would not establish health insurance exchanges, while a handful of other states said they would take advantage of an extra month allowed by the Obama administration to make decisions.
The exchanges — online markets where consumers can shop for private insurance subsidized by the federal government — are a centerpiece of President Obama’s health care law.
The administration has been urging states to set up exchanges, as Congress intended. The federal government will create and run exchanges in any state that is unable or unwilling to do so.
Mr. Obama and his health secretary, Kathleen Sebelius, have promised to give states flexibility in carrying out the new health care law and running the exchanges. However, Republican governors said they had not been allowed much latitude to date.
Gov. John R. Kasich of Ohio, a Republican, said Friday that his state “will not run an Obamacare health exchange, but will instead leave that to the federal government to do.”
“Based on the information we have,” Mr. Kasich said, “states do not have any flexibility to build and manage exchanges in ways that respond to unique needs of their citizens.”
Gov. Scott Walker of Wisconsin, another Republican opposed to the health care law, said, “From a philosophical standpoint, I prefer state-run over federal on any day on any subject.” But under the law, Mr. Walker said, “Wisconsin taxpayers will not have meaningful control over the health care policies and services sold to Wisconsin residents.”
For decades, under governors of both parties, Wisconsin has been a national leader in the regulation of insurance
LePage just one of many GOP governors defying Obamacare requirement
WASHINGTON — Maine Gov. Paul LePage is among the more than a dozen GOP governors who have announced they would not implement a key part of the new health care law, despite a new attempt by the Obama administration to give states more time to develop plans to put the Affordable Care Act in place.
LePage this week joined Ohio Gov. John Kasich, Wisconsin Gov. Scott Walker more than a dozen GOP governors who have notified the administration they will not set up state insurance exchanges next year, instead leaving the job to the federal government.
“I’m not lifting a finger,” LePage said in an interview with Bloomberg News at a Republican Governors Association meeting in Las Vegas. “We’re not going to get involved. We’re going to let Mr. Obama do a federal exchange. It’s his bill.”
Kasich’s decision drew quick praise from House Speaker John A. Boehner, R-Ohio. “I’m proud of my governor … for taking a stand and resisting the federal takeover of health care in Ohio,” said Boehner, who just last week seemed ready to soften the GOP campaign against the law, pronouncing, “Obamacare is the law of the land.”
Diabetes rate doubles in Maine, soars in the South
Posted Nov. 15, 2012, at 7:29 p.m.
MINNEAPOLIS — The number of people living with diabetes is soaring in the United States, as 18 states had at least a doubling in those with the illness since 1995, a government survey found.
Diabetics made up 6 percent or more of the population in all 50 states in 2010, an increase from just three states, the District of Columbia and Puerto Rico in 1995, according to the report from the U.S. Centers for Disease Control and Prevention.
The report shows that the diabetes rate more than doubled in Maine and several other Northern states, including Washington, Idaho, Montana, Wyoming, South Dakota, Minnesota, Missouri, and Ohio.
Rates are increasing in tandem with obesity, which has reached epidemic proportions as physical activity levels plunge and daily calorie counts soar, according to the CDC.
The findings have health and economic implications as the number of Americans with diabetes is expected to continue climbing unless effective prevention and treatment efforts are established, Ann Albright, director of the CDC’s division of diabetes translation, said. Diabetes costs topped $174 billion in 2007, the most recent numbers available, with about $1 of every $10 spent on health care going toward the disease, according to the American Diabetes Association.
“It’s potentially a big problem, and it’s a problem that is going to increase,” said Adrian Vella, an endocrinologist at the Mayo Clinic in Rochester, Minn., who studies the development of prediabetes. “The longer that people live the more likely they are to have diabetes. And the longer you have diabetes, the more likely you are to have complications from it.”
The findings in the CDC’s Morbidity and Mortality Weekly Report are based on telephone surveys conducted across the U.S. Researchers asked people if had been told they had diabetes. They didn’t differentiate between Type 1, which develops in children who stop producing the hormone insulin, and Type 2, which accounts for as many as 95 percent of cases. Type 2 diabetes, where the body doesn’t properly use insulin, generally occurs in older people who are overweight and sedentary.
“Regionally, we saw the largest increase in diagnosed diabetes prevalence in the South, followed by the West, Midwest and Northeast,” said Linda Geiss, a CDC statistician and the lead study author, in a statement. The findings confirm earlier reports that the highest numbers of people diagnosed with diabetes live in the south and the Appalachian states, she said.
The news wasn’t all bad. The increased number of people with diabetes probably stems in part from better survival among people with the disease, the CDC report said. Death rates fell faster among diabetics than those without it from 1997 through 2006 as medical care improved, national data shows.
For Alzheimer’s, Detection Advances Outpace Treatment Options
By GINA KOLATA
When Awilda Jimenez started forgetting things last year, her husband, Edwin, felt a shiver of dread. Her mother had developed Alzheimer’sin her 50s. Could his wife, 61, have it, too?
He learned there was a new brain scan to diagnose the disease and nervously agreed to get her one, secretly hoping it would lay his fears to rest. In June, his wife became what her doctor says is the first private patient in Arizona to have the test.
“The scan was floridly positive,” said her doctor, Adam S. Fleisher, director of brain imaging at the Banner Alzheimer’s Institute in Phoenix.
The Jimenezes have struggled ever since to deal with this devastating news. They are confronting a problem of the new era of Alzheimer’s research: The ability to detect the disease has leapt far ahead of treatments. There are none that can stop or even significantly slow the inexorable progression to dementia and death.
Families like the Jimenezes, with no good options, can only ask: Should they live their lives differently, get their affairs in order, join a clinical trial of an experimental drug?
“I was hoping the scan would be negative,” Mr. Jimenez said. “When I found out it was positive, my heart sank.”
The new brain scan technology, which went on the market in June, is spreading fast. There are already more than 300 hospitals and imaging centers, located in most major metropolitan areas, that are ready to perform the scans, according to Eli Lilly, which sells the tracer used to mark plaque for the scan.
The scans show plaques in the brain — barnaclelike clumps of protein, beta amyloid — that, together with dementia, are the defining feature of Alzheimer’s disease. Those who have dementia but do not have excessive plaques do not have Alzheimer’s. It is no longer necessary to wait until the person dies and has an autopsy to learn if the brain was studded with plaques.
Many insurers, including Medicare, will not yet pay for the new scans, which cost several thousand dollars. And getting one comes with serious risks. While federal law prevents insurers and employers from discriminating based on genetic tests, it does not apply to scans. People with brain plaques can be denied long-term care insurance.
The Food and Drug Administration, worried about interpretations of the scans, has required something new: Doctors must take a test showing they can read them accurately before they begin doing them. So far, 700 doctors have qualified, according to Eli Lilly. Other kinds of diagnostic scans have no such requirement.
Incredible Prices for Cancer Drugs
An unusually bold stand by doctors at the Memorial Sloan-Kettering Cancer Center in New York has forced a big drug company to reduce the cost of an overpriced drug for treating colorectal cancer that was no better than a cheaper competitor and did almost nothing to extend a patient’s life. It is a heartening sign that alert and aggressive physicians can potentially play a major role in helping to reduce the escalating costs of health care for treatments of marginal value.
The drug is Zaltrap, which was developed by Sanofi, a large French pharmaceutical company, and Regeneron Pharmaceuticals, a small biotechnology company in Tarrytown, N.Y. It was approved by the Food and Drug Administration in August as a second-line treatment for colorectal cancer after initial courses of treatment have stopped working. It is used for treating colorectal cancer that has spread from the colon to other parts of the body and is administered intravenously.
Zaltrap was initially priced at about $11,000 a month, more than double the price of a competing drug, Avastin, made by Genentech, which is itself considered too expensive by many doctors for the minimal medical benefit it delivers. When added to standard cancer treatments, both drugs improve the median survival time of patients by a minuscule 1.4 months.
Life, Death and Deficits
By PAUL KRUGMAN
America’s political landscape is infested with many zombie ideas — beliefs about policy that have been repeatedly refuted with evidence and analysis but refuse to die. The most prominent zombie is the insistence that low taxes on rich people are the key to prosperity. But there are others.
And right now the most dangerous zombie is probably the claim that rising life expectancy justifies a rise in both the Social Security retirement age and the age of eligibility for Medicare. Even some Democrats — including, according to reports, the president — have seemed susceptible to this argument. But it’s a cruel, foolish idea — cruel in the case of Social Security, foolish in the case of Medicare — and we shouldn’t let it eat our brains.
First of all, you need to understand that while life expectancy at birth has gone up a lot, that’s not relevant to this issue; what matters is life expectancy for those at or near retirement age. When, to take one example, Alan Simpson — the co-chairman of President Obama’s deficit commission — declared that Social Security was “never intended as a retirement program” because life expectancy when it was founded was only 63, he was displaying his ignorance. Even in 1940, Americans who made it to age 65 generally had many years left.
Now, life expectancy at age 65 has risen, too. But the rise has been very uneven since the 1970s, with only the relatively affluent and well-educated seeing large gains. Bear in mind, too, that the full retirement age has already gone up to 66 and is scheduled to rise to 67 under current law.
This means that any further rise in the retirement age would be a harsh blow to Americans in the bottom half of the income distribution, who aren’t living much longer, and who, in many cases, have jobs requiring physical effort that’s difficult even for healthy seniors. And these are precisely the people who depend most on Social Security.
So any rise in the Social Security retirement age would, as I said, be cruel, hurting the most vulnerable Americans. And this cruelty would be gratuitous: While the United States does have a long-run budget problem, Social Security is not a major factor in that problem.
Medicare, on the other hand, is a big budget problem. But raising the eligibility age, which means forcing seniors to seek private insurance, is no way to deal with that problem.
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