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Daily Archives: December 2, 2013

Positive effects in children after home visits by nurses, paraprofessionals

Home visits by nurses and paraprofessionals to children of low-income women had some positive benefits for the children on cognitive and behavioral measures, according to the results of a clinical trial published by JAMA Pediatrics, a JAMA Network publication.Home visits by nurses to low-income families have been promoted as one strategy to improve health and development outcomes for first-born children from those families, according to the study background.David L. Olds, Ph.D.

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New colorectal cancer target found in stem cell gene

Researchers in Canada found that switching off a gene in the cancer stem cells that drive colon cancer stops them from being able to renew themselves. They say their study offers a starting point to treatments that could shut the cancer down.Cancer stem cells are cells that have the ability to differentiate into all the types of cell that exist in that type of tumor.

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Genes and air pollution combine to increase autism risk

Children with a particular gene variant who are exposed to air pollution appear to be at a higher risk of developing autism, according to researchers from the Keck School of Medicine at the University of Southern California (USC). Drawing on results of previous studies that have shown associations between air pollution and autism, and between autism and the MET gene, the researchers say their new study reveals that the combination of these factors increases the risk of autism. The study will be published in the January 2014 edition of Epidemiology.

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Energy drinks alter heart function, study shows

Energy drinks have become a multi-billion dollar industry that continues to grow, yet regulation of this enterprise remains largely unchecked. Now, a new study shows that healthy adults who consume energy drinks have “significantly increased” heart contraction rates an hour later. The research was recently presented at the annual meeting of the Radiological Society of North America (RSNA).The study authors, including Dr.

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Administration Gives Thumbs Up To Website Fixes And Upgrades

The health law website reportedly now is operating 90 percent of the time, but more work still must be done, according to the Obama administration’s Sunday progress report on their efforts to correct healthcare.gov’s problems.  

The Washington Post: Healthcare.gov Meets Deadline For Fixes, Obama Administration Says
After a series of technical fixes and capacity upgrades, many of which were made over the past week, HealthCare.gov is now working more than 90 percent of the time — a big improvement over October, when the site was operating only about 43 percent of the time and frequently crashed, said Jeffrey Zients, the administration official overseeing the improvements. … Even with the improved performance, some people are likely to encounter problems on the site. And there is another worry — reports sent to insurance companies about who has enrolled in health plans include errors that could cause problems when people try to use their new insurance plans next year (Somashekhar and Sun, 12/1).

The Associated Press/Washington Post: Gov’t Diagnosis: Healthcare.gov On The Mend
Yet officials acknowledged more work remains on the website, which made its national debut two months ago with hundreds of software flaws, inadequate equipment and inefficient management. Federal workers and private contractors have undertaken an intense reworking of the system, but some users might still encounter trouble. How many problems are left? That’s the question consumers and lawmakers alike will be eying before the next crucial deadline: Dec. 23 (12/2).

Los Angeles Times: Major Health Website Bugs Fixed, Officials Say, But More Work Needed
The Obama administration said Sunday it had met its deadline to fix the major problems that have hobbled the federal healthcare website since its disastrous debut two months ago, but officials acknowledged that further repairs were necessary. … Administration officials concede that the site still may not be able to handle the crush of people expected to seek insurance this month. Consumers need to select health plans by Dec. 23 if they want coverage to begin Jan. 1. During peak times, some consumers may be put into a queue to gain access, officials said (Levey and Mascaro, 12/1).

Bloomberg: Obamacare Website Repair Goals Reached, Administration Says
President Barack Obama raised the stakes on his three-year-old health-care overhaul yesterday, declaring that fixes to his administration’s troubled insurance exchange website make it ready to sign up 800,000 people a day. The site, healthcare.gov, is sure to be tested immediately today — “Cyber Monday” — when deals from online retailers draw more Americans to their computers and the Internet (Wayne and Nussbaum, 12/2).

Politico: Redone Healthcare.gov Faces New Test
The test will start on what’s expected to be heavier Web traffic on Monday. And it will last through Dec. 23, the deadline for millions of people — including those who have had their policies canceled — who want to log on and get coverage that starts on Jan. 1. The soft relaunch on Sunday also resets the effort by the administration and its health care allies to have 7 million people sign up in Obamacare insurance exchanges in the next four months. If people can sign on and get covered, the White House hopes, it could start rebuilding support for President Barack Obama’s signature health law and confidence in the president himself (Haberkorn, 12/1).

Reuters: U.S. HealthCare.Gov Website Faces New Tests As Traffic Builds
President Barack Obama and his HealthCare.gov website face another critical test starting this week, as Americans who have been unable to enroll in health coverage under Obamacare rush to a site that continues to face challenges. A day after the administration said it met its weekend deadline for making HealthCare.gov operate smoothly for most users, networks of volunteer organizations are expected to resume enrollment activities after a long U.S. Thanksgiving holiday weekend, many of them with backlogs of would-be applicants waiting for access (Morgan, 12/2).

The Fiscal Times: Democrats Double-Down On Obamacare Revamp
Democrats at both the national and local levels voiced a full-throated endorsement of the Obamacare web site Sunday, one day after the administration’s self-imposed deadline to improve the broken site. Speaking on Sunday talks shows, Democrats – some of whom appeared to be wavering in their support for the troubled health care law last month – said that the fixes made to the site were a positive step. They also said that they believed the Obama administration would meet their enrollment goal of 7 million by the end of March (Francis, 12/1).

The Fiscal Times: Will Obamacare Tech Fixes Plug Political Fallout? 
The administration’s announcement over the weekend that it has achieved its promised goal of making the Obamacare website workable for the “vast majority” of users was the first piece of genuinely positive news since the disastrous rollout began Oct. 1 – one that may  have staunched the political hemorrhaging at the White House. The newly improved on-line system probably will get its first big test this week when people emerge from the Thanksgiving holiday determined to sign up or curious about the government’s claims of a vastly improving system. At the same time, critics and opponents will be watching closely or testing the system in search of new cracks (Pianin, 12/2).

Meanwhile, in terms of the numbers the site has handled so far –

Bloomberg: Obamacare Website Sign-Ups Said To Reach 100,ዀ In Month
About 100,000 people signed up for health insurance through the online federal exchange last month, a roughly four-fold increase from October even as a team of U.S. government and contractor programmers was fixing the troubled Affordable Care Act website, said a person familiar with program’s progress (Goldman, 12/2).

Marketplace: ACA Enrollment: Lessons From Social Security And Medicare
We’re coming up on two months since the government started signing folks up for the new Obamacare health exchanges, and let’s just say it hasn’t been the smoothest rollout in American history. If you look back a bit, there are a few times the government has pretty successfully managed to enroll a huge number of people. Like Social Security, and Medicare. So what’s so different this time? (LeMoult, 11/27).

Kaiser Health News also compiled Sunday’s news coverage of the Obama administration’s progress report on website fixes (12/1).

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Political Cartoon: 'No Lucy Necessary?'

Kaiser Health News provides a fresh take on health policy developments with “No Lucy Necessary?” By R.J. Matson.

Here’s today’s health policy haiku:  

GET ACTIVE

Poor drug coverage?
Exercise is medicine
The strongest there is!
-Abe Moskow

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story. 

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Consumers, Employers Face New Round Of Health Coverage Challenges, Decisions

News outlets offer consumer tips for using healthcare.gov and take a look at where things stand in terms of obtaining coverage as of Jan. 1.  

The Washington Post: Consumer Tips For Healthcare.gov Show Administration’s Cautious Optimism
The Obama administration on Sunday reported vast improvement with the HealthCare.gov health-insurance portal that opened with extensive glitches in October, while acknowledging that the site still needs more work. One sign of ongoing problems came in the form of a blog entry and infographic that Health and Human Services Secretary Kathleen Sebelius published on Huffington Post. Both items provide tips for consumers visiting the site, most notably by encouraging them to use it during off-peak hours — mornings, nights and weekends (Hicks, 12/2).

Kaiser Health News: With Three Weeks Left, Consumers Fear They May End Up Without Health Coverage On New Year’s Day
For people in the states with well-functioning insurance websites, such as California, New York and Kentucky, this appears to leave plenty of time. But making the deadline could be dicier for people in Arizona and the 35 other states where the federal website healthcare.gov is the path to coverage, as well as Oregon and Hawaii, which have struggled to get their sites functioning. On Sunday, the government reported progress in improving healthcare.gov, saying the site now allows more than 800,000 visits a day with the rate of timeouts or crashes reduced to below 1 percent. Officials said repairs continue (Rau, 12/2).

And for employers –

The Washington Post: New Health-Care Law Pushing Employers To Make Tough Decisions About Coverage
For years, Ron Peppe spent much of his time poring over contracts that his company, Canam Steel, won to build steel infrastructure in highways, stadiums and hotels, such as the underground steel foundation it just completed for the new Marriott Marquis in downtown Washington. These days, Peppe, the head of legal and human resources at Canam, whose U.S. headquarters are in Point of Rocks, Md., still reads plenty of contracts. But he is also spending much more time reading the ongoing deluge of rules and regulations coming out of federal agencies that are meant to help guide employers as they adjust their companies’ health benefits under President Obama’s signature health-care law, the Affordable Care Act (Ho, 12/1).

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Religious Liberty Issues Color Supreme Court Consideration Of Health Law's Contraception Coverage Mandate

Other challenges to the law continue to work their way through courtrooms across the country.

Politico: Contraceptive Cases Raise Religious Liberty Issues
The Supreme Court in early spring will hear two legal challenges to Obamacare’s contraception coverage requirement, a case that addresses a complex question that has never come squarely before the court: Can a for-profit company engaged in commercial activities declare religious beliefs? Under the women’s preventive health benefit in the Affordable Care Act most employers must provide all Food and Drug Administration-approved forms of contraception with no co-pays. There are exemptions for religious organizations and ways for religious-affiliated institutions to try to work around the requirement. But owners of nonreligious businesses who oppose some or all contraceptives say the government shouldn’t be able to require them to break with their religious beliefs (Haberkorn, 12/2).

USA Today: Long-Shot Legal Challenges To Health Care Law Abound
President Obama’s signature health care law could get nicked by the Supreme Court next year when the justices take up the mandate that most businesses provide free coverage for contraception. But that’s not the only legal hurdle it faces. In courtrooms across the country, Republican state attorneys general and conservative groups are challenging the way the law was passed, the way it was worded and the bureaucracy it created (Wolf, 11/29).

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Members Of Congress Get Different Health Marketplace Experience Than Most Ordinary Customers

The Los Angeles Times explores the experiences for lawmakers and their staffs as they leave the regular federal health insurance system and move to the new exchanges.

Los Angeles Times: For Congress, Health Care Plans Remain A Notch Above
Trying to align lawmakers with the people they represent, Congress three years ago decided that when the new health care plan took effect, members would give up their platinum health benefits and enroll in the online marketplaces created for millions of other Americans. In typical congressional fashion, however, things have not worked out exactly as advertised (Memoli, 12/1).

Meanwhile, several Republican doctors are running for Senate using the health law as a foil —

The Hill: Republican Doctors Running For Congress Amid Obamacare Rollout Fiasco
Eleven Republican doctors are running for the Senate, hoping that voters will see their medical expertise as an asset amid the administration’s botched rollout of Obamacare. … Doctors running in Senate races from North Carolina to Oregon are all pitching voters on their experience in the medical field (Jaffe, 12/1).

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Medicaid Expansion Could Exacerbate Doctor Shortage

As more people gain access to coverage as a result of the health law’s expansion of the state-federal insurance program for the poor, finding doctors willing to treat them may be a challenge. Other stories look at how Americans in similar circumstances face vastly different health coverage options because of where they live. That’s because half the states opted against the health law’s expansion of Medicaid.

The New York Times: Medicaid Growth Could Aggravate Doctor Shortage
Dr. Ted Mazer is one of the few ear, nose and throat specialists in [the San Diego] region who treat low-income people on Medicaid, so many of his patients travel long distances to see him. But now, as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: It does not pay enough (Goodnough, 11/28).

The Fiscal Times: Doctor Shortage Could Rise Under Medicaid Expansion
Only 25 states and the District of Columbia have signed on so far, however, as Republican governors and GOP-dominated state legislatures in most of the remaining states have opted out of the expanded program – either to protest Obamacare in general or out of fear that their states may end up having to pay a much larger share of the expanded Medicaid costs than the Obama administration promised. The result is a disturbingly stark dual system health care system determined largely by where people live and the political leanings of their home states. Now there’s an even more challenging problem: Qualifying for expanded Medicaid coverage is one thing; finding a doctor who will even accept new Medicaid patients is another (Pianin, 12/1).

Louisville Courier-Journal: Medicaid Expansion: A Case Of The Kentucky ‘Haves’ And The Indiana ‘Have-Nots’
Lorinda Fox of New Albany, Ind., hasn’t been to a doctor since her last child was born 21 years ago. Poor and uninsured, she treats her illnesses with over-the-counter remedies. … If Fox lived in Kentucky, she would qualify for expanded Medicaid next year under the Affordable Care Act. But she lives in a state where she makes too much to qualify for traditional Medicaid, and politicians have chosen not to expand Medicaid as Obamacare intended, contending that Indiana taxpayers can’t afford it. Her predicament reveals an irony in the way Obamacare’s Medicaid expansion has played out: Residents in similar circumstances face vastly different health coverage options, depending on which side of the Ohio River they live (Ungar, 12/1).

Detroit Free Press: Eligible For Medicaid? Many In Michigan Face Bureaucratic Confusion
Across Michigan, hundreds of thousands of residents who may be eligible for the state’s Medicaid expansion remain in frustrating, bureaucratic limbo — one that could push arguably affordable coverage out of their reach if they don’t get answers soon. Those residents won’t know for sure until next year whether they’re eligible for an expanded Medicaid under the health reform law. But for many, it could be too late to access tax credits now to make policies more affordable on the Michigan Health Insurance Marketplace, or state exchange (Erb, 12/2).

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