G.O.P. Is Wary That Health Care Win Could Have Its Own Risks
By ROBERT PEAR
By ROBERT PEAR
WASHINGTON — Republicans who have been hoping that the Supreme Court will upend President Obama’s health care law are now confronting an urgent and uncomfortable question: What if they win?
Republicans in Congress would face an enormously complicated challenge to fashion an alternative, and they fear the fallout could lead to election losses if millions of Americans abruptly found themselves without health insurance.
If the court voids a federal rule allowing subsidies in states that use the federal insurance marketplace, many Republicans said, they would support a temporary continuation of subsidies for people with low or moderate incomes.
“Our goal is to protect people, not the law,” said Senator John Barrasso, Republican of Wyoming, who has been charged by his party with devising a possible legislative response to the court decision expected by the end of this month.
Democrats denounced the proposals, saying they would increase the number of uninsured and drive up premiums. But Republicans said a full-scale replacement for the health law would not be their immediate objective.
It’s Not Just About Bad Choices
BALTIMORE
WHENEVER I write about people who are struggling, I hear from readers who say something like: Folks need to stop whining and get a job. It’s all about personal responsibility.
In a 2014 poll, Republicans were twice as likely to say that people are poor because of individual failings as to say the reason is lack of opportunity (Democrats thought the opposite). I decided to ask some of the poor what they think. Here in Baltimore, I consulted Andrew Jackson Phillips Jr., 28, who’s been homeless for the last eight years or so, and he thinks that there is something to the personal responsibility narrative.
“I had multiple chances,” he acknowledged. “I made some bad choices” — although he added that he thought “the system” had failed him as well.
I asked about his childhood. Phillips said that his mother had been a drug addict and that he may have been born with drugs in his system. His siblings had had acute lead poisoning, and he may have had toxic lead levels as well, with lifelong cognitive and behavioral consequences. At age 3, Phillips said he saw his brother shot dead. At age 5, he himself was shot in the head by a drug dealer (he showed me the scar). In the eighth grade, he dropped out of school.
Sure, he made bad choices. Who among us, after going through his traumatic childhood, could be sure of making optimal choices?
Too often, I believe, liberals deny that poverty is linked to bad choices. As Phillips and many other poor people acknowledge, of course, it is.
Self-destructive behaviors — dropping out of school, joining a gang, taking drugs, bearing children when one isn’t ready — compound poverty. Researchers have often found that very poor families worldwide spend more of their income on alcohol than on educating their children. And, in central Kenya, a government study published a few years ago found that men there, on average, spent more of their salaries on alcohol than on food.
Yet scholars are also learning to understand the roots of these behaviors, and they’re far more complicated than the conservative narrative of human weakness.
For starters, there is growing evidence that poverty and mental health problems are linked in complex, reinforcing ways. In the United States, a Gallup poll a few years ago found that people living in poverty were twice as likely to have been diagnosed with depression as other Americans. One study in 2010 found that 55 percent of American babies living in poverty in 2001 were raised by mothers showing signs of depression.
The journal JAMA Psychiatry last year estimated that millions of low-income Americans suffer from parasitic infections such as toxocariasis and toxoplasmosis that, in turn, are associated with cognitive impairment or mental health disorders.
“I estimate 12 million Americans living in poverty suffer from at least one neglected parasitic or tropical disease,” says Dr. Peter Hotez, the author of that study. “The media places so much emphasis on imaginary infectious disease threats, when millions of people in poverty, mostly people of color, have neglected infections that are almost completely ignored.”
If you’re battling mental health problems, or grow up with traumas like domestic violence (or seeing your brother shot dead), you’re more likely to have trouble in school, to self-medicate with drugs or alcohol, to have trouble in relationships.
Anthem, other health insurers are eyeing consolidation
By CHAD TERHUNE
Another consolidation wave may be coming to the health insurance industry with Anthem Inc. playing a major role.
Analysts have pegged Anthem as one of three potential bidders for Humana Inc., which is prized for its big presence in the Medicare Advantage program.
Then Monday, the Wall Street Journal reported that Anthem has made a bid for Cigna Corp., the nation's fifth-largest health insurer by enrollment. Aetna Inc. has also expressed interest in Cigna, according to multiple reports.
Amid all the speculation, analysts agree the health insurance industry is ripe for consolidation.
"Like many industries, we think the managed care industry will evolve to a Big 3," said Ana Gupte, a healthcare analyst at Leerink Partners. "One of the reasons that we think a wave of consolidation is overdue is that we view the industry as being too fragmented."
Gupte said if Anthem loses out on Humana, then a deal for Cigna might be more likely.
A spokeswoman for Anthem said the company won't comment on rumors or speculation.
Target selling pharmacy, clinic businesses to CVS Health
By ASSOCIATED PRESS
Target will sell its pharmacy and clinic businesses to the drugstore chain CVS Health for about $1.9 billion in a deal that combines the resources of two retailers seeking to polish their health care reputations.
The acquisition allows CVS Health to reach more patients and expand its in-store MinuteClinic brand, which it has been growing aggressively for the past several years. It also gives the nation's second-largest drugstore chain a retail presence in new markets like Seattle, Denver, and Salt Lake City.
Target customers, in turn, will gain access to CVS Health Corp.'s pharmacy care programs that help them manage their prescriptions, find low-cost generic drugs and buy specialty medications, a rapidly growing slice of the pharmaceutical market.
Drugstore chains, grocers and big retailers like Target and Wal-Mart have all pushed deeper into customer health in recent years, in part to serve the aging baby boom generation and the millions of uninsured people who are expected to gain coverage under the federal health care overhaul. They've added walk-in clinics to their stores and, in some cases, expanded the care those clinics provide to include monitoring chronic conditions like diabetes.
Retailers also are putting more health care products on their shelves.
Drugstores have long-since slowed their push to grow by building new stores and shifted to expanding what their existing stores offer. That includes groceries and other non-pharmacy items, aside from health care products, as they try to attract customers who are looking to buy more in a single stop.
CVS Health gained national attention last year when it announced it would pull tobacco from its store shelves as part of a push to improve its reputation as a health care provider. The drugstore chain also changed its name to CVS Health from CVS Caremark last year as part of its increased focus on health.
Target had already quit selling tobacco in 1996.
House rejects bill to extend anti-discrimination law to people who don’t vaccinate
AUGUSTA, Maine — Lawmakers on Monday rejected an effort to expand the Maine Human Rights Act to people who choose not to be vaccinated.
The act protects people from discrimination on the basis of race, color, sex, sexual orientation, physical or mental disability, religion, ancestry or national origin.
The bill, LD 950, would have added “vaccination status” to that list of protected classes. It was rejected by the House of Representatives in 102-42 vote. The bill faces further action in the Senate, but is likely dead.
The state requires students to be vaccinated for several ailments before they can attend school, unless there is a valid medical, religious or philosophical reason to skip vaccination. Some public employees, such as teachers, can also be required to vaccinate.
The bill’s sponsor, Rep. David Sawicki, R-Auburn, said those requirements amount to discrimination against those who want to keep their bodies free of vaccines.
The bill is necessary to “protect your rights from an overzealous government who would compel you to take a medicine because they believe it’s right for you,” Sawicki said. “If a woman has a right to control her reproductive system, surely I have a right to control my immune system.”
Rep. Linda Sanborn, D-Gorham, argued vaccination is important not only for the individual who receives the vaccine, but for protecting people who cannot be vaccinated due to medical conditions that make it dangerous. Sanborn, a doctor, called the bill a “dangerous piece of legislation.”
Obamacare's final test: if it survives the Supreme Court, it's here to stay
Updated by Sarah Kliff on June 15, 2015
In the next two weeks, the Supreme Court will rule inKing v. Burwell, a challenge that threatens to dismantle Obamacare by ending financial subsidies for 6.4 million Americans.
If the challengers win, it would throw the health-care law into chaos. But if the White House prevails, something equally momentous will have occurred: President Obama's signature legislative accomplishment will actually, really, definitely be here to stay.
"This Court challenge is the last point at which it seems really like that the law could completely go away," says Larry Levitt, a vice president at the Kaiser Family Foundation.
Politically, momentum to repeal Obamacare is waning. Legally, Obamacare opponents are simply running out of ideas. And perhaps most importantly, Obamacare now has a large and growing constituency: an estimated 10.2 million Americans get coverage through the health law's marketplace (and millions more through Obamacare's Medicaid expansion).
"If we win this, I think that's major, and I'd call it a monumental step," says Ron Pollack, executive director of the pro-Obamacare advocacy group Families USA. "It means that the ACA is a permanent part of the American health-care system."
F.D.A. Sets 2018 Deadline to Rid Foods of Trans Fats
WASHINGTON — The Food and Drug Administration on Tuesday gave the food industry three years to eliminate artery-clogging artificial trans fats from the food supply, a long-awaited step that capped years of effort by consumer groups and is expected to save thousands of lives a year.
Trans fats — a major contributor to heart disease in the United States — have already been substantially reduced in foods, but they still lurk in many popular products, including frostings, microwave popcorn, packaged pies, frozen pizzas, margarines and coffee creamers.
The agency announced its plans to act in 2013 and has since addressed more than 6,000 public comments. The decision Tuesday was final and would effectively remove industrial trans fats from the American diet by 2018, a change that the agency has estimated could prevent 20,000 heart attacks and 7,000 deaths from heart disease each year.
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