California lawmakers will push death-with-dignity measure
By PATRICK MCGREEVY
It was a dying wish of Brittany Maynard, after terminal cancer led her to move to Portland so she could legally end her life, that her home state of California would someday adopt Oregon's death-with-dignity law.
On Wednesday, less than three months after 29-year-old Maynard's death drew international attention to the issue, her husband and mother stood with nine California lawmakers to announce legislation that would allow physicians in this state to prescribe medications to hasten death for the terminally ill.
"This option is something that Brittany and I thought should be available to all Californians," her husband, Dan Diaz, said at an emotional Capitol news conference.
"She recognized that to stay in California would mean that she potentially would face a horrific death," Diaz said. "Brittany was a Californian. We lived in this state and she would have preferred to pass away peacefully in this state."
Four states besides Oregon — Montana, New Mexico, Vermont and Washington — also allow terminally ill patients to seek medical help to die. Legislation to permit it in California has failed twice, opposed on religious grounds and by many doctors, among others.
With Maynard's consent, the group Compassion & Choices set up a Brittany Maynard Fund to raise money for a campaign to enact assisted suicide laws across the country. Active efforts are underway in New York, Pennsylvania, Nevada and several other places, according to Patricia A. González-Portillo, a spokeswoman for Compassion & Choices.
If California lawmakers do not adopt such a law, González-Portillo said, the group may take the issue to voters: "We are prepared to go to the ballot in 2016, but we are hoping to make this happen" through legislation.
By PATRICK MCGREEVY
It was a dying wish of Brittany Maynard, after terminal cancer led her to move to Portland so she could legally end her life, that her home state of California would someday adopt Oregon's death-with-dignity law.
On Wednesday, less than three months after 29-year-old Maynard's death drew international attention to the issue, her husband and mother stood with nine California lawmakers to announce legislation that would allow physicians in this state to prescribe medications to hasten death for the terminally ill.
"This option is something that Brittany and I thought should be available to all Californians," her husband, Dan Diaz, said at an emotional Capitol news conference.
"She recognized that to stay in California would mean that she potentially would face a horrific death," Diaz said. "Brittany was a Californian. We lived in this state and she would have preferred to pass away peacefully in this state."
Four states besides Oregon — Montana, New Mexico, Vermont and Washington — also allow terminally ill patients to seek medical help to die. Legislation to permit it in California has failed twice, opposed on religious grounds and by many doctors, among others.
With Maynard's consent, the group Compassion & Choices set up a Brittany Maynard Fund to raise money for a campaign to enact assisted suicide laws across the country. Active efforts are underway in New York, Pennsylvania, Nevada and several other places, according to Patricia A. González-Portillo, a spokeswoman for Compassion & Choices.
If California lawmakers do not adopt such a law, González-Portillo said, the group may take the issue to voters: "We are prepared to go to the ballot in 2016, but we are hoping to make this happen" through legislation.
New Senate bill would overturn Obamacare's individual mandate
BY DAVID MORGAN
(Reuters) - Leading Republican senators on Wednesday introduced a bill to repeal one of Obamacare's most unpopular provisions - the individual mandate that requires most Americans to obtain health insurance or pay a penalty.
Senator Orrin Hatch, chairman of the Senate Finance Committee, and Senator Lamar Alexander, who heads the Senate Health, Education, Labor and Pensions Committee, announced the three-paragraph bill titled, the American Liberty Restoration Act, with backing from 20 other Republican co-sponsors.
It was the first time that legislation to eliminate the mandate, a linchpin of President Barack Obama'sAffordable Care Act, has been introduced by a Senate majority party.
The mandate survived a 2012 U.S. Supreme Court challenge seeking to overturn it on constitutional grounds. It has now become part of a new Republican effort to chip away at the legislative underpinnings of the law known as Obamacare.
Aides said the bill should eventually come to a vote. But it was unclear whether the measure would overcome potential blocking tactics by Democrats.
BY DAVID MORGAN
(Reuters) - Leading Republican senators on Wednesday introduced a bill to repeal one of Obamacare's most unpopular provisions - the individual mandate that requires most Americans to obtain health insurance or pay a penalty.
Senator Orrin Hatch, chairman of the Senate Finance Committee, and Senator Lamar Alexander, who heads the Senate Health, Education, Labor and Pensions Committee, announced the three-paragraph bill titled, the American Liberty Restoration Act, with backing from 20 other Republican co-sponsors.
It was the first time that legislation to eliminate the mandate, a linchpin of President Barack Obama'sAffordable Care Act, has been introduced by a Senate majority party.
The mandate survived a 2012 U.S. Supreme Court challenge seeking to overturn it on constitutional grounds. It has now become part of a new Republican effort to chip away at the legislative underpinnings of the law known as Obamacare.
Aides said the bill should eventually come to a vote. But it was unclear whether the measure would overcome potential blocking tactics by Democrats.
Obamacare Pays for Insurers Who Fought It as Stocks Rise
By Drew Armstrong and Doni Bloomfield
U.S. health insurers that waged a campaign against Obamacare hit an all-time high on the stock market Wednesday after UnitedHealth Group Inc. (UNH)said it would add hundreds of thousands of new customers because of the law.
The Standard & Poor’s 500 Managed Health Care Index -- which includes the five biggest U.S. insurers -- closed at 1,031.18 on Wednesday in New York, the highest level since at least 1994. Health insurers have said that the Affordable Care Act has cost them billions in taxes and fees -- including $1 billion in 2014 for UnitedHealth -- and burdened them with new regulations.
The Affordable Care Act requires all Americans to have health insurance. To do so, it created marketplaces for people to buy coverage, often with subsidies, and expanded Medicaid, the joint federal-state program for the poor.
That’s meant millions of new customers.
“We got something like 15 to 16 million people through those two channels, and about 10 million people were previously uninsured,” said Ana Gupte, an analyst at Leerink Partners. “That’s new growth that this industry never experienced before.”
By Drew Armstrong and Doni Bloomfield
U.S. health insurers that waged a campaign against Obamacare hit an all-time high on the stock market Wednesday after UnitedHealth Group Inc. (UNH)said it would add hundreds of thousands of new customers because of the law.
The Standard & Poor’s 500 Managed Health Care Index -- which includes the five biggest U.S. insurers -- closed at 1,031.18 on Wednesday in New York, the highest level since at least 1994. Health insurers have said that the Affordable Care Act has cost them billions in taxes and fees -- including $1 billion in 2014 for UnitedHealth -- and burdened them with new regulations.
The Affordable Care Act requires all Americans to have health insurance. To do so, it created marketplaces for people to buy coverage, often with subsidies, and expanded Medicaid, the joint federal-state program for the poor.
That’s meant millions of new customers.
“We got something like 15 to 16 million people through those two channels, and about 10 million people were previously uninsured,” said Ana Gupte, an analyst at Leerink Partners. “That’s new growth that this industry never experienced before.”
The People Most at Risk of Losing Insurance in the Supreme Court’s Health Ruling
The people who could lose their health insurance as a result of a Supreme Courtdecision this year are predominantly white, Southern, employed and middle-aged, according to an Urban Institute analysis.
The case, called King v. Burwell, concerns whether federal subsidies that help middle-income Americans buy their health insurance can be distributed in every state, or just those that are running their own marketplaces. A ruling for the challengers could mean that residents of more than 30 states would lose subsidies. Some would be immediately priced out of the market. Others would be expected to lose coverage later, after insurers raised prices to account for the change. The Urban Institute analysis estimated that, over all, two-thirds of people receiving subsidies would drop coverage if those subsidies disappeared, and a quarter of people paying their entire premiums would also become uninsured.
The Affordable Care Act helped about 10 million Americans obtain health insurance last year — and more people have signed up for the law’s coverage programs in the last few months. But not everyone who has such insurance would be affected if the Supreme Court ruled for the plaintiffs. Its effects would be limited to residents of certain states and certain income groups.
My colleague Kevin Quealy and I have written about the groups that have gained the most from Obamacare so far: blacks, Hispanics, young adults, rural Americans and those with the lowest incomes. But the group that stands to lose the most from the court case has a markedly different profile.
The people who could lose their health insurance as a result of a Supreme Courtdecision this year are predominantly white, Southern, employed and middle-aged, according to an Urban Institute analysis.
The case, called King v. Burwell, concerns whether federal subsidies that help middle-income Americans buy their health insurance can be distributed in every state, or just those that are running their own marketplaces. A ruling for the challengers could mean that residents of more than 30 states would lose subsidies. Some would be immediately priced out of the market. Others would be expected to lose coverage later, after insurers raised prices to account for the change. The Urban Institute analysis estimated that, over all, two-thirds of people receiving subsidies would drop coverage if those subsidies disappeared, and a quarter of people paying their entire premiums would also become uninsured.
The Affordable Care Act helped about 10 million Americans obtain health insurance last year — and more people have signed up for the law’s coverage programs in the last few months. But not everyone who has such insurance would be affected if the Supreme Court ruled for the plaintiffs. Its effects would be limited to residents of certain states and certain income groups.
My colleague Kevin Quealy and I have written about the groups that have gained the most from Obamacare so far: blacks, Hispanics, young adults, rural Americans and those with the lowest incomes. But the group that stands to lose the most from the court case has a markedly different profile.
Maine ACA Sign-Ups Skyrocket, But Some Still Struggle to Find Care
By PATTY WIGHT • 17 HOURS AGO
LEWISTON, Maine - The number of Mainers who purchased insurance in the Affordable Care Act's online marketplace has already sky-rocketed beyond last year's record statistics.
With a little less than a month to go before the enrollment period closes, more than 61,000 have signed up. The goal behind the marketplace is to increase access to care, but some Mainers are still struggling to get the services they need.
Patty Wight visited a recently re-opened free health clinic in Lewiston to find out who is still stuck in the outskirts of the system.
The clinic is in the basement of a church, just a few blocks from downtown Lewiston. This is the home of the Trinity Jubilee Center, a non-religious organization that provides a variety of services.
On a Thursday morning in January, the place is packed. Some sip coffee at tables. Others collect groceries from the food pantry. More than a dozen also sign up for the free health clinic, which is tucked in a cramped back office.
Among them is Jeffrey. He'd rather not share his last name, but doesn't mind explaining why he is here. "I have an abscess in my tooth," he says. "I've been on penicillin for 12 days. And I'm in extraordinary amounts of pain, and any dentist you talk to wants a huge co-pay and I'm reaching dead ends everywhere I've gone."
Jeffrey has Social Security Disability Insurance, but says he has virtually no dental coverage. He came to this free clinic to see if the doctor who runs it - Alice Haines - could help. But after his appointment, he still doesn't see any viable options.
By PATTY WIGHT • 17 HOURS AGO
LEWISTON, Maine - The number of Mainers who purchased insurance in the Affordable Care Act's online marketplace has already sky-rocketed beyond last year's record statistics.
With a little less than a month to go before the enrollment period closes, more than 61,000 have signed up. The goal behind the marketplace is to increase access to care, but some Mainers are still struggling to get the services they need.
Patty Wight visited a recently re-opened free health clinic in Lewiston to find out who is still stuck in the outskirts of the system.
The clinic is in the basement of a church, just a few blocks from downtown Lewiston. This is the home of the Trinity Jubilee Center, a non-religious organization that provides a variety of services.
On a Thursday morning in January, the place is packed. Some sip coffee at tables. Others collect groceries from the food pantry. More than a dozen also sign up for the free health clinic, which is tucked in a cramped back office.
Among them is Jeffrey. He'd rather not share his last name, but doesn't mind explaining why he is here. "I have an abscess in my tooth," he says. "I've been on penicillin for 12 days. And I'm in extraordinary amounts of pain, and any dentist you talk to wants a huge co-pay and I'm reaching dead ends everywhere I've gone."
Jeffrey has Social Security Disability Insurance, but says he has virtually no dental coverage. He came to this free clinic to see if the doctor who runs it - Alice Haines - could help. But after his appointment, he still doesn't see any viable options.
Physicians blame patient 'treadmill' for missed calls
By Sabriya Rice | January 17, 2015
For a physician to deliver an accurate diagnosis, it requires time for thoughtful consideration of a patient's symptoms.
But time is one element physicians say they don't have these days as they scramble to maximize patient throughput, an unfortunate side effect of a payment system still dominated by fee-for-service medicine.
The growing constraints on physician time have emerged as a major cause of missed or wrong diagnoses, experts say. And those errors account for about 1 in 6 incidents of system-induced patient harm, which causes more than 100,000 deaths a year, according to some estimates.
While the U.S. patient-safety movement has focused enormous attention on medical errors over the past few decades, diagnostic errors have received less attention from practitioners, the research community or patient-safety advocates. The extent of the problem is hard to assess as missed diagnoses remain a largely unreported phenomenon.
The Institute of Medicine, which first called attention to the extent of the patient-safety problem, barely mentioned diagnostic errors in its historic 1999 To Err Is Human report. But now it is finally tackling the issue.
The IOM will issue a report this year that will raise a red flag over the issue and give advocates the intellectual firepower needed to get more resources focused on this cause of patient harm.
By Sabriya Rice | January 17, 2015
For a physician to deliver an accurate diagnosis, it requires time for thoughtful consideration of a patient's symptoms.
But time is one element physicians say they don't have these days as they scramble to maximize patient throughput, an unfortunate side effect of a payment system still dominated by fee-for-service medicine.
The growing constraints on physician time have emerged as a major cause of missed or wrong diagnoses, experts say. And those errors account for about 1 in 6 incidents of system-induced patient harm, which causes more than 100,000 deaths a year, according to some estimates.
While the U.S. patient-safety movement has focused enormous attention on medical errors over the past few decades, diagnostic errors have received less attention from practitioners, the research community or patient-safety advocates. The extent of the problem is hard to assess as missed diagnoses remain a largely unreported phenomenon.
The Institute of Medicine, which first called attention to the extent of the patient-safety problem, barely mentioned diagnostic errors in its historic 1999 To Err Is Human report. But now it is finally tackling the issue.
The IOM will issue a report this year that will raise a red flag over the issue and give advocates the intellectual firepower needed to get more resources focused on this cause of patient harm.
But time is one element physicians say they don't have these days as they scramble to maximize patient throughput, an unfortunate side effect of a payment system still dominated by fee-for-service medicine.
The growing constraints on physician time have emerged as a major cause of missed or wrong diagnoses, experts say. And those errors account for about 1 in 6 incidents of system-induced patient harm, which causes more than 100,000 deaths a year, according to some estimates.
While the U.S. patient-safety movement has focused enormous attention on medical errors over the past few decades, diagnostic errors have received less attention from practitioners, the research community or patient-safety advocates. The extent of the problem is hard to assess as missed diagnoses remain a largely unreported phenomenon.
The Institute of Medicine, which first called attention to the extent of the patient-safety problem, barely mentioned diagnostic errors in its historic 1999 To Err Is Human report. But now it is finally tackling the issue.
The IOM will issue a report this year that will raise a red flag over the issue and give advocates the intellectual firepower needed to get more resources focused on this cause of patient harm.
Americans See Healthcare, Low Wages as Top Financial Problems
by Art Swift
WASHINGTON, D.C. -- Healthcare costs and lack of money or low wages rank as the most important financial problems facing American families, each mentioned by 14% of U.S. adults. Fewer Americans than a year ago cite the high cost of living or unemployment, and the percentage naming oil or gas prices is down from 2012.
Gallup has been asking Americans about the most important financial problem facing their family in an open-ended format for the past 10 years. Healthcare this year has returned to the top of the list for the first time since early 2010, when the Affordable Care Act, or "Obamacare," was signed into law. Still, Americans viewed it as an even bigger financial problem in 2007, when a range of 16% to 19% said it was most important.
Notably, 6% of Americans see the high cost of living or inflation as their family's biggest financial problem, down from 13% just over three years ago. And in today's era of sub-$50-per-barrel oil, only 2% name energy costs, or oil or gas prices as their most important financial problem, down significantly from 11% in 2012 amid a spike in oil prices.
The percentage who don't mention any financial problem is up five percentage points from last year, to 17%. This sizable uptick suggests that the economic recovery may be reducing the financial problems that families face.
Most Important Financial Problems Vary Across Income Groups
For Americans earning $75,000 or more a year, retirement savings, college expenses and healthcare costs rank as the most important financial problems. Among lower-income Americans, retirement savings and college expenses are less important. Healthcare costs, however, have double-digit-percentage support across the board.
by Art Swift
WASHINGTON, D.C. -- Healthcare costs and lack of money or low wages rank as the most important financial problems facing American families, each mentioned by 14% of U.S. adults. Fewer Americans than a year ago cite the high cost of living or unemployment, and the percentage naming oil or gas prices is down from 2012.
Gallup has been asking Americans about the most important financial problem facing their family in an open-ended format for the past 10 years. Healthcare this year has returned to the top of the list for the first time since early 2010, when the Affordable Care Act, or "Obamacare," was signed into law. Still, Americans viewed it as an even bigger financial problem in 2007, when a range of 16% to 19% said it was most important.
Notably, 6% of Americans see the high cost of living or inflation as their family's biggest financial problem, down from 13% just over three years ago. And in today's era of sub-$50-per-barrel oil, only 2% name energy costs, or oil or gas prices as their most important financial problem, down significantly from 11% in 2012 amid a spike in oil prices.
The percentage who don't mention any financial problem is up five percentage points from last year, to 17%. This sizable uptick suggests that the economic recovery may be reducing the financial problems that families face.
Most Important Financial Problems Vary Across Income Groups
For Americans earning $75,000 or more a year, retirement savings, college expenses and healthcare costs rank as the most important financial problems. Among lower-income Americans, retirement savings and college expenses are less important. Healthcare costs, however, have double-digit-percentage support across the board.
Can getting sick push you into foreclosure?
Piles of research link foreclosure to depression, increased emergency room visits and even suicide among people who have lost their homes or are close to it. But just as foreclosures can contribute to health problems, new research shows that health problems can contribute to foreclosure, as well.
Middle-aged adults with chronic conditions that got worse as they grew older are nearly twice as likely to default on their mortgages and 2.6 times as likely to lapse into foreclosure than those whose chronic conditions remained stable, according to a recent study that tracked people as they hit their 40th and 50th birthdays during the foreclosure crisis.
The study concluded that those who got sicker from 2007 through 2010 were more likely to lose their jobs, and therefore their income and health insurance, which heightened their chances of foreclosure. But even people who weren't grappling with job loss and its consequences were more likely to default, possibly because they struggled with high medical costs, the study said.
In other words, even with the foreclosure crisis behind us, the economy improving and a new health care law in effect that provides expanded coverage for millions of Americans, it's still extremely expensive to get sick in this country. And one of the consequences may be losing your house.
War Over Obamacare Heats Up In States
by Fred Schulte
Oklahoma state Rep. Mike Ritze is a foot soldier — one of hundreds — in a passionate war over the Affordable Care Act that is reigniting as state legislatures convene across the country.
The Republican lawmaker, a family doctor, has stood behind three anti-Obamacare bills supported by conservative groups in Oklahoma and other states. None has made it into law, but Ritze plans to pick up the fight in the 2015 legislative session that convenes in the Sooner State next month.
"We need to do everything we can to try and reverse this," said Ritze, who practices in Broken Arrow.
In Washington, D.C., there's been little consensus on modifying the health care law. But in state capitals around the country, from Albany and Columbia to Austin and Sacramento, lawmakers have been mulling over hundreds of proposals that reflect many starkly different views on Obamacare as settled law.
A Center for Public Integrity review found that more than 700 Obamacare-related bills were filed in the states during 2014 or carried over from 2013 in states where legislatures allow that. (You can read in-depth about the center's findings here.)
Some states saw 50 or more health bills each, according to data from the National Conference of State Legislatures, or NCSL. It's not yet clear how many will be reconsidered in 2015 — many states are just kicking off their legislative sessions — but few expect any substantial retreat from the battlefront.
A Bit Of Everything
Some bills seek to "nullify" the law or find creative ways to hinder its enforcement, while others are perennial filings inspired by Tea Party activists and other early foes of Obamacare, such as the John Birch Society.
Dozens of anti-Obamacare bills appear to take their cues from a handful of activist groups — some well-financed at least partly by big corporate donors, and others run on shoestring budgets.
On the flip side, scores of bills to bulk up Obamacare have also landed in state hoppers, especially last year. Most would either expand eligibility for Medicaid, the health care plan for low-income people funded by states and the federal government, or require insurers to cover more medical services.
NCSL data show that to date, pro-Obamacare forces have had the upper hand in bills actually signed into law. In all, more than 75 Obamacare-related bills were signed into law in 2014. About 50 moved the law forward, mostly by expanding Medicaid, while the rest appeared to impede its reach. But the tide may be shifting. Conservative groups that have tried to peck away at the law say they feel energized by Republican gains in state legislatures in 2014 midterm elections.
Style And Substance
Harvard University sociologist Theda Skocpol, a supporter of the law, said that some of the anti-Obamacare bills are "largely symbolic" and stand little chance of passage, but that others can put significant pressure on state governments.
Congress passed the Affordable Care Act in 2010 to help pay for health care coverage for millions of uninsured Americans. But the law leaves some key decisions on how to do so partly up to the states.
State lawmakers also are awaiting the Supreme Court's decision over the legality of subsidies paid in states that did not set up their own exchanges. A ruling in the case, King v. Burwell, is due this summer.
That would no doubt result in a new flood of proposals. But state lawmakers haven't been shy about weighing in to date.
Among the trends:
- More than 200 bills, most sponsored by Republicans, have attacked Obamacare's foundation from different flanks. At least 25 bills seek to repeal or "nullify" it, while others would offset any fines collected from people who refuse to purchase health insurance, or otherwise limit the law's reach. A "model" bill considered in at least 11 states would forbid state employees from enforcing any part of the law. Most didn't pass.
- At least 85 bills would tinker with insurance exchanges set up by the states or the federal government to sell policies. Just over half would choke off funding or inhibit exchanges by cutting off their spending on marketing or advertising. Four bills would stop insurers from taking any federal subsidies, though none passed. Most of these bills have failed.
- More than 55 bills filed in about two dozen states tried to tighten oversight of "navigators," who assist people in choosing a health plan that best fits their needs. Obamacare supporters see these bills as little more than a ruse to disrupt the law, and most did not pass. Yet six states in 2014 passed laws to tighten training standards or bar felons from getting these jobs.
- At least 26 states have taken up bills that would petition Congress to let states make health care financing decisions. Nine states have joined these health care compacts, data show. Nine compact bills were put forward in six states during 2013 and 2014, but only Kansas approved one, in 2014.
- More than 100 bills, most sponsored by Democrats, would expand Obamacare by covering more lower-income people under Medicaid or requiring insurers to cover new medical services. Most did not pass.
Organized Opposition
One high-profile group fighting Obamacare in statehouses is the American Legislative Exchange Council, or ALEC. The "free-market" group says it works to "advance limited government."
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